MICHAEL OLUFAWO MD
NPI 1033962360
Radiology - Diagnostic Radiology in Saint Louis, MO
About Michael Olufawo Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MICHAEL OLUFAWO MD (NPI 1033962360) is an individual diagnostic radiology provider in Saint Louis, Missouri, licensed in Missouri (2024022794) and active in the NPI registry since April 2024. He is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Michael Olufawo Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 63141 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
SAINT LOUIS, MO 63141
SAINT LOUIS, MO 63141
SAINT LOUIS, MO 63141
SAINT LOUIS, MO 63141
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Michael Olufawo's NPI number?
The NPI number for Michael Olufawo is 1033962360. It was assigned to this individual provider in the NPPES registry on April 8, 2024.
Where is Michael Olufawo located?
Michael Olufawo practices at 621 S New Ballas Rd, Saint Louis, MO 63141. The listed phone number is (621) 301-9631.
What is Michael Olufawo's specialty?
The primary specialty registered for this NPI is Radiology, specializing in Diagnostic Radiology, with taxonomy code 2085R0202X.
Is Michael Olufawo enrolled in Medicare?
Yes. Michael Olufawo is registered in the Medicare PECOS enrollment system.
When was this NPI record last updated?
The NPPES record for Michael Olufawo was last updated on June 17, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Michael Olufawo, MD · NPI 1033962360
Diagnostic Radiology physician in Saint Louis, Missouri. Individual provider, active in the CMS NPPES registry since April 8, 2024.
## Identity
- **NPI:** 1033962360 (Entity type: Individual)
- **Enumerated:** April 8, 2024
- **Primary specialty:** Radiology - Diagnostic Radiology · taxonomy 2085R0202X
- **State license:** 2024022794 (Missouri)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 621 S NEW BALLAS RD, Saint Louis, MO 63141-8232
- **Phone:** (621) 301-9631
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
## Record status
- **NPPES last updated:** June 17, 2024
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Source: [NPI Profile](https://npiprofile.com/npi/1033962360) · Data from the CMS NPPES public registry.