MEDICARE: MOSHOOD ADEBAYO LAWAL 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
1	208M00000X	Hospitalist Physician	TD091053	ME
2	208M00000X	Hospitalist Physician	50599	WI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1457559296
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MOSHOOD ADEBAYO LAWAL M.D

Provider Business Mailing Address
First Line	:	1 MEDICAL CENTER DR
Second Line	:
City	:	BIDDEFORD
State	:	ME
Zip	:	04005-9422
Country	:	US
Telephone Number	:	207-283-7000
Fax Number	:

Provider Business Practice Location Address
First Line	:	1165 W LODGEWOOD CT
Second Line	:
City	:	RIVER HILLS
State	:	WI
Zip	:	53217-1637
Country	:	US
Telephone Number	:	770-490-1156
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/03/2007
Last Update Date	:	11/11/2025

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