Individual
DR. OLUMIDE OLOLADE ADEWUMI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
500 PORTER AVE, AURORA, MO 65605-2365
(417) 678-7888
Mailing address
PO BOX 504274, SAINT LOUIS, MO 63150-4274
(855) 420-7900
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2016023769
MO
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
MO
Enumeration date
07/12/2013
Last updated
07/21/2016
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