Individual
DR. ADEDAPO M ODUWOLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1203 48TH AVE N, 202, MYRTLE BEACH, SC 29577-5425
(843) 449-2576
(843) 449-6851
Mailing address
1203 48TH AVE N, 202, MYRTLE BEACH, SC 29577-5425
(843) 449-2576
(843) 449-6851
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
31507
SC
2084P0800X
Psychiatry Physician
43425
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
31507
—
SC
05
—
34116200
—
WI
Enumeration date
01/16/2007
Last updated
03/21/2014
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