Individual provider · Type 1 NPI
Osayande Stephen Izeiyamu, MD
General Practice Physician · Lake City, FL
NPI number
1255698619
Active
Practice location
194 SW Wall Ter
Lake City, FL 32025-5086
Fax (386) 719-9488
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Medicine Physician | 207Q00000X | BP10043366 (TX) |
| General Practice Physician Primary | 208D00000X | ACN634 (FL) |
General Practice Physician: A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.
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About NPI 1255698619
Osayande Stephen Izeiyamu, MD's National Provider Identifier is 1255698619, issued on Apr 23, 2012. The primary taxonomy on file is General Practice Physician (208D00000X), and the practice location is in Lake City, FL. The record was last updated on Jan 20, 2016.