Individual
TOLULOLA OMOLOLU ADEOLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1370 W D ST, NORTH WILKESBORO, NC 28659-3506
(336) 716-2255
Mailing address
PO BOX 601643, CHARLOTTE, NC 28260-1643
(704) 355-0720
(704) 355-5948
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
200400005
NC
207R00000X
Internal Medicine Physician
23570
SC
208M00000X
Hospitalist Physician
Primary
200400005
NC
208M00000X
Hospitalist Physician
23570
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1578582797
—
NC
05
—
23570
—
SC
05
—
235702
—
SC
Enumeration date
07/19/2006
Last updated
06/08/2021
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