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Individual

DR. ADEKUNLE OLUWATOSIN OBISESAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
625 S NEW BALLAS RD, SAINT LOUIS, MO 63141-8240
(314) 251-6486
(314) 251-4155
Mailing address
625 S NEW BALLAS RD STE 7020, SAINT LOUIS, MO 63141-8218
(314) 251-6486
(314) 251-4155

Taxonomy

Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
2022012233
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1164604138
MO
Enumeration date
12/03/2007
Last updated
07/06/2022
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