Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Tiwadayo Cecilia Sam-Odusina, MD

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1235749839

Tiwadayo Cecilia Sam-Odusina, MD is a Pediatric Medicine in Providence, Rhode Island. Qualified in 2019, 7 years ago. Practices as a sole proprietor and works from 2 locations. Licensed in New Jersey and Rhode Island.

Years since qualifying
7
Licensed in
NJ, RI
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

593 Eddy St
Providence, RI 02903-4923
Phone: (401) 444-4471
Fax: (401) 444-7574
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 101 Dudley St, Providence, RI 02905-2401 — (401) 274-1122

Specialties & licences

Pediatric Pulmonology Physician (primary) Taxonomy 2080P0214X · Licence MD21092 (RI)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X (NJ)

Record details

NPI number1235749839
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorYes
NPI enumeratedAugust 7, 2020
Last updated in NPPESJune 2, 2026
Certification dateJune 2, 2026

Medicare enrollment

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

Medicare specialtyPEDIATRIC MEDICINE
Also practisesPULMONARY DISEASE
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Accepts Medicare assignment Not indicated
Practice locations4 on file with Medicare

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