Individual
OLADUNNI MODUPEOLA ADETOBA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D
Contact information
Practice address
1001 GAUSE BLVD # 4, SLIDELL, LA 70458-2939
(985) 280-8743
(985) 280-8554
Mailing address
1001 GAUSE BLVD # 4, SLIDELL, LA 70458-2939
(985) 280-8743
(985) 280-8554
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
323946
LA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/16/2017
Last updated
02/11/2021
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