Provider Demographics
NPI:1841819950
Name:IYAMAH, MONISOLA OLUWAKEMI JOANN (MD)
Entity type:Individual
Prefix:DR
First Name:MONISOLA
Middle Name:OLUWAKEMI JOANN
Last Name:IYAMAH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2001 N JEFFERSON AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:MT PLEASANT
Mailing Address - State:TX
Mailing Address - Zip Code:75455-2375
Mailing Address - Country:US
Mailing Address - Phone:903-575-5151
Mailing Address - Fax:
Practice Address - Street 1:2001 N JEFFERSON AVE STE 300
Practice Address - Street 2:
Practice Address - City:MT PLEASANT
Practice Address - State:TX
Practice Address - Zip Code:75455-2375
Practice Address - Country:US
Practice Address - Phone:903-575-5151
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-09
Last Update Date:2025-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXU5331208000000X
IN01090785A208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics