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General NPI Number Information
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NPI Number | 1669531489
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Entity Type | Individual
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Provider Name | ROLAND AKINYEDE M.D.
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Gender | Male
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Dates
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Enumeration Date | 12/07/2006
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Last Update Date | 12/23/2007
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Provider Practice Location Address
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Address Line | 3394 MCKELVEY RD SUITE 106
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City | BRIDGETON
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State | MO
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Zip | 63044-2531
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Country | US
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Telephone | 314-485-5404
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Fax | 314-485-5407
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Provider Business Mailing Address
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Address Line | 144 FRONTENAC FRST
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City | FRONTENAC
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State | MO
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Zip | 63131-3220
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Country | US
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Telephone | 314-485-5404
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Fax | 314-485-5407
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 2001025556
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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License Number | 2001025556
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License Number State | MO
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