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FASAN, OMOTAYO OLUSOLA       
This verification service provides current data extracted by the Oklahoma State Board of Medical Licensure and Supervision (OSBMLS) from its own database. The data enclosed in the green box below is provided by and controlled entirely by the OSBMLS and therefore constitutes a primary source verification of licensure status as authentic as a direct inquiry to the OSBMLS. NPI# and hospital privileges (if any) are provided by the licensee and not verified.
Practice Address: LEVINE CANCER INSTITUTE CAROLINAS HEALTHCARE
1021 MOREHEAD MEDICAL DRIVE
SUITE 5300
CHARLOTTE NC 28204-2993

Address last updated on 3/20/2016
Phone #: (980) 442-4000
Fax #:
County: NOT OKLAHOMA
License: 31277
Dated: 4/13/2015
Expires: 4/1/2016
License Type: Medical Doctor
Specialty: Hematology (Internal Medicine)
Internal Medicine
Status: Inactive
Status Class: Expired License
Restricted to:
Registered to Dispense: NO
Medical School: Univ Of Lagos, Coll Of Med, Lagos, Nigeria
Graduated: 8 / 1995
CME Year: 2018
Pending and/or Past Disciplinary Actions: No Disciplinary Action Taken.
All information below is entered by the licensee but not verified by the Oklahoma Medical Board.
Certifications: AMERICAN BOARD OF INTERNAL MEDICINE
AMERICAN BOARD OF INTERNAL MEDICINE - Hematology
New Patients: Contact licensee
Medicaid: Contact licensee
Medicare: Contact licensee
   
HMO/PPO: None listed
Hospital Privileges: None listed
Locations: Hours: Languages:
LEVINE CANCER INSTITUTE CAROLINAS HEALTHCARE
1021 MOREHEAD MEDICAL DRIVE
SUITE 5300
CHARLOTTE NC 28204-2993

Phone #: (980) 442-4000
Fax #:

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