Provider Demographics
NPI:1174718365
Name:SULAIMAN, OLAWALE A R (MD, PHD)
Entity type:Individual
Prefix:DR
First Name:OLAWALE
Middle Name:A R
Last Name:SULAIMAN
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:DR
Other - First Name:WALE
Other - Middle Name:
Other - Last Name:SULAIMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1514 JEFFERSON HWY
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70121
Mailing Address - Country:US
Mailing Address - Phone:504-842-4000
Mailing Address - Fax:
Practice Address - Street 1:1514 JEFFERSON HIGHWAY
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70121
Practice Address - Country:US
Practice Address - Phone:504-842-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-11
Last Update Date:2009-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI50000207T00000X
LAMD.202346207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS01228712Medicaid
LA1313831Medicaid
MS01228712Medicaid
LA1313831Medicaid