Healthcare Provider Details

I. General information

NPI: 1023958865
Provider Name (Legal Business Name): FAOLA MEDICAL SERVICES PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/31/2026
Last Update Date: 03/31/2026
Certification Date: 03/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

131 S CENTER ST # 849
COLLIERVILLE TN
38017-3068
US

IV. Provider business mailing address

PO BOX 849
COLLIERVILLE TN
38027-0849
US

V. Phone/Fax

Practice location:
  • Phone: 347-922-8050
  • Fax:
Mailing address:
  • Phone: 347-922-8050
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. ABOSEDE SHOWUNMI
Title or Position: PROVIDER/OWNER
Credential: MD
Phone: 347-922-8050