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1952976292
MOFOLUWASO IBIWOYE
LONGVIEW, TX
NPI
1952976292
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
(Licence: TX BP10075219)
Enumeration Date
2021-05-20
Last Update Date
2021-10-28
Business Address
MOFOLUWASO IBIWOYE MD
701 E MARSHALL AVE STE 400
LONGVIEW, TX 75601-5595
Phone number: 903-315-5600
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Mailing Address
MOFOLUWASO IBIWOYE MD
701 E MARSHALL AVE STE 400
LONGVIEW, TX 75601-5595
Phone number: 903-315-5171
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