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Individual

OLAIDE IFELOLA AJAYI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
776 WEATHERLY DR, SUITE A, CLARKSVILLE, TN 37043-8941
(931) 906-2004
(931) 906-2009
Mailing address
PO BOX 440100, NASHVILLE, TN 37244-0100
(931) 906-2004
(931) 906-2009

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
D0066606
MD
207RH0003X
Hematology & Oncology Physician
Primary
48841
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
102101696-0001
PA
05
3810010307
WV
05
413550400
MD
01
P00461544
TRAVELERS MEDICARE
MD
Enumeration date
10/17/2007
Last updated
07/27/2012
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