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General NPI Number Information
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NPI Number | 1164487955
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Entity Type | Individual
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Provider Name | MOJIBOLA OLAYINKA SOLAJA M.D.
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Gender | Female
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Dates
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Enumeration Date | 04/18/2006
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Last Update Date | 10/30/2012
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Provider Practice Location Address
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Address Line | 120 WILDEWOOD PARK DR SUITE B
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City | COLUMBIA
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State | SC
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Zip | 29223-4300
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Country | US
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Telephone | 803-788-7882
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Fax | 803-788-1828
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Provider Business Mailing Address
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Address Line | 120 WILDEWOOD PARK DR SUITE B
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City | COLUMBIA
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State | SC
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Zip | 29223-4300
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Country | US
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Telephone | 803-788-7882
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Fax | 803-788-1828
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080A0000X
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Taxonomy Name | Pediatric Adolescent Medicine Physician
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License Number | 21514
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License Number State | SC
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