Provider Demographics
NPI:1578228557
Name:BABATOLA, OLUWADAMILOLA J (MD, MBA)
Entity type:Individual
Prefix:
First Name:OLUWADAMILOLA
Middle Name:J
Last Name:BABATOLA
Suffix:
Gender:F
Credentials:MD, MBA
Other - Prefix:
Other - First Name:LOLA
Other - Middle Name:
Other - Last Name:BABATOLA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:144 N RAVENEL ST
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29506-2641
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:144 N RAVENEL ST
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29506-2641
Practice Address - Country:US
Practice Address - Phone:843-777-2566
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-03
Last Update Date:2025-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCLL94708207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine