Organization
MOBOLAJI SHALOM OYEBANJO, INC
Active
Other names
The Potter Behavioral Medicine Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MOBOLAJI OYEBANJO MD (PROVIDER)
(770) 459-8799
Entity
Organization
Contact information
Practice address
307 OLD STONE RD, VILLA RICA, GA 30180-1214
(770) 459-8799
(770) 459-8919
Mailing address
307 OLD STONE RD, VILLA RICA, GA 30180-1214
(770) 459-8799
(770) 459-8919
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
2084P0800X
Psychiatry Physician
Primary
—
—
2084P0802X
Addiction Psychiatry Physician
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
327161185A
—
GA
05
—
327161185B
—
GA
Enumeration date
12/04/2007
Last updated
10/03/2012
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us