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NPI Code Detail

MEDICARE: DR. MOPELOLA ISOLA M.D

MEDICARE: DR. MOPELOLA ISOLA M.D
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208M00000XHospitalist Physician72995GA
2207R00000XInternal Medicine Physician25MA07009800NJ
3208M00000XHospitalist Physician214661NY
4207R00000XInternal Medicine Physician72995GA
5208M00000XHospitalist Physician036174795IL

General Provider Information

NPI Number : 1073514808
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MOPELOLA ISOLA M.D
Provider Business Mailing Address
First Line : 2518 JIMMY LEE SMITH PKWY
Second Line :
City : HIRAM
State : GA
Zip : 30141-2068
Country : US
Telephone Number : 470-732-4022
Fax Number : 470-732-4023
Provider Business Practice Location Address
First Line : 2450 RIVERSIDE AVE
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55454-1450
Country : US
Telephone Number : 612-672-6000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/02/2005
Last Update Date : 12/08/2025

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