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Individual

DR. AYODELE OLUMIDE ERINLE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1901 RED ROCK DR, GALLUP, NM 87301-5683
(505) 863-7933
(505) 863-9406
Mailing address
1801 REDROCK DR, GALLUP, NM 87301-5655
(505) 863-7933
(505) 863-9406

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD2007-0583
NM
207R00000X
Internal Medicine Physician
D0062023
MD
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
MD427577
PA
207RN0300X
Nephrology Physician
MD2007-0583
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
83432361
NM
Enumeration date
05/20/2006
Last updated
04/05/2019
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