Organization
SHALOM CLINIC FOR CHILDREN APMC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. OLUSEGUN ADEDAMOLA ADELEYE M.D. (PRESIDENT)
(318) 356-7211
Entity
Organization
Contact information
Practice address
405 BIENVILLE ST, NATCHITOCHES, LA 71457-5748
(318) 356-7211
(318) 356-7226
Mailing address
405 BIENVILLE ST, NATCHITOCHES, LA 71457-5748
(318) 356-7211
(318) 356-7226
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
200937
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1949574
—
LA
Enumeration date
12/19/2006
Last updated
11/23/2011
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