Individual
MOSHOOD OLATINWO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
617A BIENVILLE ST, NATCHITOCHES, LA 71457-5730
(318) 352-1108
(318) 352-1106
Mailing address
617A BIENVILLE ST, NATCHITOCHES, LA 71457-5730
(318) 352-1108
(318) 352-1106
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
MD.203547
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000973233
—
GA
05
—
009911284
—
AL
05
—
009911291
—
AL
05
—
09001250
—
MS
05
—
2100882
—
LA
01
—
51542720
BCBS - 1610 CENTER ST
AL
01
—
515542695
BCBS - 1720 CENTER ST
AL
Enumeration date
07/29/2005
Last updated
04/20/2015
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