Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | T0166 | TX |
N | 207VX0000X | Obstetrician | A96140107462882 | NJ |
NPI | 1013406818 |
---|---|
Provider Name | Adeola Awomolo |
First Address | Shenandoah, TX 77380-2794 |
Second Address | New Brunswick, NJ 08901-1962 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/05/2018 |
Last Update Date | 03/11/2021 |