Individual
ISIAKA OLAWALE SHOLABI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3050 COMMERCE DR, SUITE C CREDENTIALS, FORT GRATIOT, MI 48059-3819
(810) 385-8086
(810) 385-4933
Mailing address
381 BROAD ST APT 707A, NEWARK,NJ, NEWARK, NJ 07104-5314
(646) 417-1127
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
Primary
061654
GA
208M00000X
Hospitalist Physician
4301087339
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4301087339
PHYSICIAN LICENSE
MI
Enumeration date
06/04/2006
Last updated
03/19/2019
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