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NPI Code Detail

MEDICARE: DR. OLUFUNMILOLA AJALA MD

MEDICARE: DR. OLUFUNMILOLA AJALA 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
1208M00000XHospitalist Physician036176804IL
2207R00000XInternal Medicine Physician036176804IL

General Provider Information

NPI Number : 1821618760
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. OLUFUNMILOLA AJALA MD
Provider Business Mailing Address
First Line : PO BOX 959203
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63195-9203
Country : US
Telephone Number : 618-463-7240
Fax Number : 618-463-7216
Provider Business Practice Location Address
First Line : 1 MEMORIAL DR
Second Line :
City : ALTON
State : IL
Zip : 62002-6722
Country : US
Telephone Number : 618-463-7240
Fax Number : 618-463-7216
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/21/2020
Last Update Date : 03/02/2026

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