Healthcare Provider Details

I. General information

NPI: 1891655353
Provider Name (Legal Business Name): PEACE O SHOBAYO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/17/2025
Last Update Date: 11/17/2025
Certification Date: 11/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 FOGG RD
SOUTH WEYMOUTH MA
02190-2432
US

IV. Provider business mailing address

55 FOGG RD
SOUTH WEYMOUTH MA
02190-2432
US

V. Phone/Fax

Practice location:
  • Phone: 781-624-8000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VB0002X
TaxonomyObesity Medicine (Obstetrics & Gynecology) Physician
License Number000-000-000
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: