Shadol LLC

NPI #1154506061 in Hayti, Missouri

Provider Information

NPI Number: 1154506061
Entity Type: Organization
Organization Name: Shadol LLC
Primary Specialty: Pediatrics
Enumeration Date: Jan 9, 2008
Last Updated: Mar 25, 2008

Practice Location

Address: 907 E REED ST
City: Hayti
State: Missouri
ZIP Code: 63851-1242
Phone: (573) 359-3660

Authorized Official

Name: DR. OLUMIDE OYEFESO, M.D.
Title: SOLE MEMBER
Phone: (718) 300-4515

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pediatrics	208000000X	Primary

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