Adeyanju, Moses O.

Adeyanju, Moses O. is an individual health care provider with primary practice located at 405 W Jackson St Pathology Department, Carbondale IL 62901-1462. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology, which is considered as his primary health care specialty. Adeyanju, Moses O. can be contacted via phone (618) 549-0721.

Contact Information

Primary practice address
405 W Jackson St Pathology Department Carbondale IL 62901-1462
Phone: (618) 549-0721
Fax: (618) 351-4957
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology 207ZP0102X 036-077955 Illinois

Profile Details

NPI number 1306820121
LBN Legal business name Adeyanju, Moses O.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 5th, 2005
Last updated Jun 13th, 2014 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1306820121 NPPES
Illinois MEDICAID 036077955-2

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