Provider Demographics
NPI:1073704375
Name:ADENE-PETER, RUTH ADETOUN (MD)
Entity Type:Individual
Prefix:
First Name:RUTH
Middle Name:ADETOUN
Last Name:ADENE-PETER
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 1:1245 TOWN CENTRE VILLAGE DR APT 4122
Mailing Address - Street 2:
Mailing Address - City:MCDONOUGH
Mailing Address - State:GA
Mailing Address - Zip Code:30253-6174
Mailing Address - Country:US
Mailing Address - Phone:678-982-4849
Mailing Address - Fax:
Practice Address - Street 1:485 HIGHWAY 29 N
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30601-5583
Practice Address - Country:US
Practice Address - Phone:706-438-4080
Practice Address - Fax:706-438-4081
Is Sole Proprietor?:No
Enumeration Date:2007-08-05
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY50160207Q00000X
GA63282207Q00000X
WI71041208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine