Individual
AYODEJI SEGUN OLUDIMU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NURSE
Contact information
Practice address
1905 PHEASANT CREEK LN, PEABODY, MA 01960-4731
(978) 210-1894
Mailing address
1905 PHEASANT CREEK LN, PEABODY, MA 01960-4731
(978) 210-1894
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LN85373
MA
Other
Enumeration date
07/11/2019
Last updated
07/11/2019
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