# THE 4TH MAN LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1730029331
- **Authorized official:** OLUSHOLA MOSES ADEWOLE MD (PROVIDER)
- **Authorized official phone:** (248) 897-6045

## Contact information

- **Practice address:** 7241 MEMORIAL AVE, DETROIT, MI 48228-3518
- **Practice address phone:** (248) 897-6045
- **Mailing address:** 7241 MEMORIAL AVE, DETROIT, MI 48228-3518
- **Mailing address phone:** (248) 897-6045

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 03/31/2026
- **Last updated:** 03/31/2026