Individual
AIDELOJE A. ONIME
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1133 MEDICAL DR, TYLER, TX 75701-2130
(903) 595-5486
(903) 595-5128
Mailing address
1133 MEDICAL DR, TYLER, TX 75701-2130
(903) 595-5486
(903) 595-5128
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
34634
OK
207RN0300X
Nephrology Physician
Primary
N2698
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200643170A
—
OK
05
—
2027484-02
—
TX
Enumeration date
02/06/2007
Last updated
04/20/2023
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