Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Omotola O Balogun, MD

Individual provider Emergency Medicine Physician · NPI 1982221750

Dr. Omotola O Balogun, MD is an Internal Medicine in Wynnewood, Pennsylvania. Qualified in 2013, 13 years ago. Practices with Main Line Healthcare, a 1,153-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in Pennsylvania.

Years since qualifying
13
Licensed in
PA
In the registry since
2020
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

100 E Lancaster Ave Ste 4303
Wynnewood, PA 19096-3450
Phone: (484) 476-4139
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 5501 Old York Rd Ste 1, Philadelphia, PA 19141-3098 — (240) 264-9067
  • 2601 Holme Ave, Philadelphia, PA 19152-2007 — (215) 335-7705

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X · Licence MD4819834 (PA)
Emergency Medicine Physician Taxonomy 207P00000X · Licence MD481834 (PA)

Record details

NPI number1982221750
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedJune 28, 2020
Last updated in NPPESApril 24, 2024
Certification dateApril 24, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyINTERNAL MEDICINE
Also practisesHOSPITALIST
Medical schoolOTHER
Graduated 2013 (13 years in practice)
Group practice Main Line Healthcare — 1153 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

Other providers in Wynnewood