Basic Information
Provider Information
NPI: 1215167895
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SALAU
FirstName: MUSKINNI
MiddleName: OLANREWAJU
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1 HOSPITAL DR
Address2: DC018.00
City: COLUMBIA
State: MO
PostalCode: 652121000
CountryCode: US
TelephoneNumber: 5738828885
FaxNumber: 5738844808
Practice Location
Address1: 1 HOSPITAL DR
Address2: DC018.00
City: COLUMBIA
State: MO
PostalCode: 652121000
CountryCode: US
TelephoneNumber: 5738828006
FaxNumber: 5738845396
Other Information
ProviderEnumerationDate: 07/17/2009
LastUpdateDate: 09/12/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2084P0800X2013008003MOY Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry

No ID Information.


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