Individual
DR. ERHIME T BADEJO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D MSN
Contact information
Practice address
305 W JACKSON ST STE 200, CARBONDALE FAMILY MEDICINE, CARBONDALE, IL 62901-1474
(618) 536-6621
(618) 453-1102
Mailing address
305 W JACKSON ST STE 200, CARBONDALE FAMILY MEDICINE, CARBONDALE, IL 62901-1474
(618) 536-6621
(618) 453-1102
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
2004020321
MO
207Q00000X
Family Medicine Physician
Primary
125067577
IL
208D00000X
General Practice Physician
125067577
IL
363L00000X
Nurse Practitioner
2004020321
MO
Other
Enumeration date
12/15/2005
Last updated
10/16/2015
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