Individual
DR. ADEBOWALE ANSELM OBAITAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1430 LUCKENBACH DR, ALLEN, TX 75013-4632
(972) 390-8133
(972) 390-9258
Mailing address
1430 LUCKENBACH DR, ALLEN, TX 75013-4632
(972) 390-8133
(972) 390-9258
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
051994
GA
207R00000X
Internal Medicine Physician
M6319
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2211482626
TRICARE SOUTH
GA
01
—
52025889003
BCBS
GA
05
—
688786920C
—
GA
Enumeration date
09/20/2005
Last updated
07/23/2007
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us