Provider Demographics
NPI:1639276272
Name:REHOBOTH MEDICAL SERVICES PLLC
Entity Type:Organization
Organization Name:REHOBOTH MEDICAL SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ADEREMI
Authorized Official - Middle Name:
Authorized Official - Last Name:ADEWUYI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-384-0273
Mailing Address - Street 1:632 MUSTANG RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:MURPHY
Mailing Address - State:TX
Mailing Address - Zip Code:75094-4208
Mailing Address - Country:US
Mailing Address - Phone:972-384-0273
Mailing Address - Fax:972-384-0273
Practice Address - Street 1:632 MUSTANG RIDGE DR
Practice Address - Street 2:
Practice Address - City:MURPHY
Practice Address - State:TX
Practice Address - Zip Code:75094-4208
Practice Address - Country:US
Practice Address - Phone:972-384-0273
Practice Address - Fax:972-384-0273
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty