OLUFUNMILOLA OWOTOMO M.B., CH.B.
NPI 1073315735
Student in an Organized Health Care Education/Training Program in Saint Louis, MO

Q: What is Olufunmilola Owotomo's NPI number?

The NPI number for Olufunmilola Owotomo is 1073315735. It was assigned to this individual provider in the NPPES registry on March 25, 2025.

Q: What is Olufunmilola Owotomo's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Active since March 25, 2025PECOS Enrolled

1465 S GRAND BLVD, SAINT LOUIS, MO 63104(314) 577-5634(314) 577-5616 Get Directions Write a Review

NPPES record last updated: April 1, 2025. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Apr 1, 2025, Mar 25, 2025 (2 updates tracked since 2025).

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About Olufunmilola Owotomo M.b., Ch.b. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

OLUFUNMILOLA OWOTOMO M.B., CH.B. (NPI 1073315735) is an individual student in an organized health care education/training program in Saint Louis, Missouri and active in the NPI registry since March 2025. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1073315735

Entity TypeIndividualFemale

Primary Taxonomy390200000X

Provider Legal NameOLUFUNMILOLA OWOTOMOCredential: M.B., CH.B.

Location Address1465 S GRAND BLVDSaint Louis, MO 63104-1003

Mailing Address1465 S Grand BlvdSaint Louis, MO 63104-1003 · (314) 577-5634 · Fax (314) 577-5616

Phone(314) 577-5634

Fax(314) 577-5616

Sole ProprietorNo

Enumeration DateMarch 25, 2025

Last NPPES UpdateApril 1, 20252 updates tracked since enumeration

NPPES CertifiedApril 1, 2025

✔ NPI 1073315735 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

1465 S GRAND BLVD, Saint Louis, MO 63104

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Olufunmilola Owotomo M.b., Ch.b. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

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.

ADRIENNE G TILBOR DO

Physical Medicine & Rehabilitation