Organization
HEAL MEDICAL GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AYOOLA AYOBANJI AYOOLA MD (PHYSICIAN)
(302) 741-0204
Entity
Organization
Contact information
Practice address
200 BANNING ST, SUITE #300, DOVER, DE 19904-3485
(302) 741-0204
(302) 674-5874
Mailing address
200 BANNING ST, SUITE 300, DOVER, DE 19904-3485
(302) 367-5808
(302) 674-5874
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
C1-0007939
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100041565
—
DE
Enumeration date
11/29/2007
Last updated
07/24/2012
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