Benedict Olusola Md Pa

NPI 1396833125 - Specialist - 174400000X

NPI Details
NPI 1396833125
Enumeration Date 10/10/2006
Last Updated 09/18/2012
Entity Type Healthcare Provider
Active Over 10 years ago
Authorized Information
Name MARVELLA L MARVELLA
Position OFFICE MANAGER
Phone (972) 228-3677
Fax (972) 228-3672
Practice Location
1700 N HAMPTON RD
STE 100
DESOTO TX, 75115-2392, US
Phone (972) 228-3677
Fax (972) 228-3672
Business Location
PO BOX 628
DESOTO TX, 75115-8302, US
Phone (972) 228-3677
Fax (972) 228-3672
Toxanomy
Taxonomy Code 174400000X
License State
License Number
Remove 1396833125 NPI Number
 

According to our database, Benedict Olusola Md Pa NPI is 1396833125, taxonomy code is 174400000X Benedict Olusola Md Pa physically located at 1700 N Hampton Rd, Desoto TX, 75115-2392. NPI Number 1033115704 has the healthcare provider type.

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1396833125 NPI number is provided on an as is basis without warranty of any kind. 1396833125 is maintained by the National Plan & Provider Enumeration System. The contents of Benedict Olusola Md Pa are for informational purposes only.