Ayodele, Ayotunde Kofoworola
Ayodele, Ayotunde Kofoworola is an sole proprietor health care provider with primary practice located at 430 S Herlong Ave Suite 104, Rock Hill SC 29732-9446. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Ayodele, Ayotunde Kofoworola can be contacted via phone (803) 980-6610.Contact Information
Primary practice address
430 S Herlong Ave Suite 104
Rock Hill SC 29732-9446
Phone: (803) 980-6610
Fax: (803) 980-6162
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | SC 21581 | South Carolina |
Profile Details
| NPI number | 1902887706 |
|---|---|
| LBN Legal business name | Ayodele, Ayotunde Kofoworola |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Nov 9th, 2005 |
| Last updated | Jul 8th, 2007 - about 18 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1902887706 | NPPES |
| South Carolina | MEDICAID | GP2934 |
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