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General NPI Number Information
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NPI Number | 1477583482
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Entity Type | Individual
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Provider Name | MOSES OYEGOKE ADEDEJI MD
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Gender | Male
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Dates
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Enumeration Date | 07/04/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 400 VETERANS AVENUE DIAGNOSTIC MEDICINE SERVICE (113)
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City | BILOXI
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State | MS
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Zip | 39531
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Country | US
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Telephone | 228-523-5542
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Fax | 228-523-4902
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Provider Business Mailing Address
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Address Line | 310 ABBEY CT APT A2
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City | BILOXI
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State | MS
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Zip | 39531-4009
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Country | US
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Telephone |
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Fax |
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 17620
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License Number State | MS
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Taxonomy #2
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 35.081298
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | M0335
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License Number State | TX
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