Individual
OLUFEMI ADELEYE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1890 GOODMAN RD E, SUITE 101, SOUTHAVEN, MS 38671-9504
(662) 536-1892
Mailing address
PO BOX 366, SOUTHAVEN, MS 38671-0005
(901) 681-9895
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
18315
MS
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
18315
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
06180721
—
MS
Enumeration date
05/20/2006
Last updated
10/12/2011
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