Individual
OLUADE A. AJAYI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MBBS
Contact information
Practice address
1200 SIXTH AVE NO, CENTRACARE CLINIC, ST CLOUD, MN 56303-2735
(320) 252-5731
Mailing address
1200 SIXTH AVE NO, CENTRACARE CLINIC, ST CLOUD, MN 56303-2735
(320) 252-5731
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
45643
MN
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
036070002
IL
2080N0001X
Neonatal-Perinatal Medicine Physician
45643
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
09 25 2003
MMSI
—
01
—
1034801
PREFERRED ONE
—
01
—
171809
U CARE
—
01
—
1908369
ARAZ GROUP
—
01
—
2115953
FIRST HEALTH PLAN
—
01
—
274R4AJ
BLUE CROSS BLUE SHIELD
—
01
—
458988200
MEDICAL ASSISTANCE MA
—
05
—
458988200
—
MN
01
—
4700129
MEDICA HEALTH PLANS
—
01
—
COM
GREAT WEST
—
01
—
COMP
ONE HEALTH PLAN
—
01
—
HP39081
HEALTH PARTNERS
—
01
—
NE
RR MEDICARE
—
Enumeration date
11/15/2005
Last updated
03/23/2016
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