MR. OLUKAYODE ADE ODUWOLE PA
NPI 1306984711
Physician Assistant - Medical in Southfield, MI

Q: What is Olukayode Oduwole's NPI number?

The NPI number for Olukayode Oduwole is 1306984711. It was assigned to this individual provider in the NPPES registry on February 1, 2007.

Q: What is Olukayode Oduwole's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Q: When was this NPI record last updated?

The NPPES record for Olukayode Oduwole was last updated on May 18, 2016. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since February 01, 2007PECOS Enrolled

20755 GREENFIELD RD, SUITE #203, SOUTHFIELD, MI 48075(248) 395-2206(248) 395-0456 Get Directions Write a Review

NPPES record last updated: May 18, 2016. Verified against the NPPES registry weekly; last sync: July 26, 2026.

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About Mr. Olukayode Ade Oduwole Pa NPPES

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

MR. OLUKAYODE ADE ODUWOLE PA (NPI 1306984711) is an individual medical provider in Southfield, Michigan, licensed in Michigan (5601002421) and active in the NPI registry since February 2007. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1306984711

Entity TypeIndividualMale

Primary Taxonomy363AM0700X

Provider Legal NameMR. OLUKAYODE ADE ODUWOLECredential: PA

Location Address20755 GREENFIELD RD, SUITE #203Southfield, MI 48075-5403

Mailing Address19871 Northbrook Dr, Suite #203Southfield, MI 48076-5053 · (248) 395-2206 · Fax (248) 395-0456

Phone(248) 395-2206

Fax(248) 395-0456

Sole ProprietorNo

Enumeration DateFebruary 1, 2007

Last NPPES UpdateMay 18, 2016

✔ NPI 1306984711 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363AM0700X

License✔ Licensed in MI · 5601002421

20755 GREENFIELD RD, Southfield, MI 48075

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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)

Mr. Olukayode Ade Oduwole Pa 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.

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