Organization
MOFDAPS AND COMPANY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ADEDAPO MOFOLUS ODUWOLE M.D. (OWNER)
(843) 449-2576
Entity
Organization
Contact information
Practice address
1203 48TH AVE N, 202, MYRTLE BEACH, SC 29577-5425
(843) 449-2576
(843) 449-6851
Mailing address
PO BOX 50817, MYRTLE BEACH, SC 29579-0014
(843) 449-2576
(843) 449-6851
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
31507
SC
2084P0800X
Psychiatry Physician
43425
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
31507
—
SC
05
—
34116200
—
WI
Enumeration date
06/29/2009
Last updated
10/28/2009
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