Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | 25MA09168400 | NJ |
Y | 111NI0900X | Internist | 25MA09168400 | NJ |
NPI | 1003050022 |
---|---|
Provider Name | Dr. Jubril Oyekanmi Oyeyemi |
First Address | Marlton, NJ 08053-3425 |
Second Address | Mount Holly, NJ 08060-2038 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/04/2009 |
Last Update Date | 19/10/2020 |