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

Individual provider Pediatrics Physician · NPI 1184184608

Olusegun Obafemi Owotomo, MD is a Pediatric Medicine in Saint Louis, Missouri. Qualified in 2019, 7 years ago. Works from 2 locations. Licensed in Maryland and Missouri.

Years since qualifying
7
Licensed in
MD, MO
In the registry since
2019
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

1465 S Grand Blvd
Saint Louis, MO 63104-1003
Phone: (314) 268-6439
Fax: (314) 268-2798
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 200 N Wolfe St Ste 3075, Baltimore, MD 21287-0011 — (410) 955-2035

Specialties & licences

Pediatric Pulmonology Physician (primary) Taxonomy 2080P0214X · Licence 2025031593 (MO)
Pediatrics Physician Taxonomy 208000000X · Licence D0093346 (MD)

Record details

NPI number1184184608
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedMarch 21, 2019
Last updated in NPPESAugust 26, 2025
Certification dateAugust 26, 2025

Medicare enrollment

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

Medicare specialtyPEDIATRIC MEDICINE
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Accepts Medicare assignment Not indicated

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