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NPI Code Detail

MEDICARE: DR. OJO M OLADIMEJI MD

MEDICARE:  DR. OJO M OLADIMEJI  MD
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
1207R00000XInternal Medicine Physician27042SC

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2DF5588OTHERSCRR MEDICARE GIN/PTAN
3SC24946494OTHERSCMEDICARE PIN FETTER HEALTH CARE NETWORK
5P00789441OTHERSCRAILROAD MEDICARE

Other Identifiers

General Provider Information

NPI Number : 1427065291
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. OJO M OLADIMEJI MD
Provider Business Mailing Address
First Line : 113 ASHLEY HILL DR
Second Line :
City : GOOSE CREEK
State : SC
Zip : 29445-7109
Country : US
Telephone Number : 843-572-9270
Fax Number :
Provider Business Practice Location Address
First Line : 51 NASSAU ST
Second Line :
City : CHARLESTON
State : SC
Zip : 29403-5513
Country : US
Telephone Number : 843-722-4112
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/02/2006
Last Update Date : 07/21/2015

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