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Contact Information

MOBOLAJI SHALOM OYEBANJO, INC
307 OLD STONE RD
VILLA RICA, GA30180-1214
 Phone: 770-459-8799
 Fax: 770-459-8919
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Psychiatry

2084P0800X 26 Physician/Psychiatry
 

Addiction Psychiatry

2084P0802X 86 Physician/Neuropsychiatry
 

Family Medicine

207Q00000X 08 Physician/Family Practice
 

Mental Health (Including Community Mental Health Center)

261QM0801X B4[14] Community Mental Health Center
Indicates primary specialty

NPI Profile & details for MOBOLAJI SHALOM OYEBANJO, INC

NPI # 1922280684
LBN Legal business name MOBOLAJI SHALOM OYEBANJO, INC
Authorized official MOBOLAJI OYEBANJO - (PROVIDER)
Entity Organization
Organization subpart 1 No
Enumeration date 12/04/2007
Last updated 10/03/2012 - About 14 years ago
Identifiers
GA Medicaid 327161185A
GA Medicaid 327161185B
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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