Provider Demographics
NPI:1114090511
Name:ADU-BENIAKO, SOLOMON (MD)
Entity Type:Individual
Prefix:DR
First Name:SOLOMON
Middle Name:
Last Name:ADU-BENIAKO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20905 GREENFIELD RD STE 608
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48075-5355
Mailing Address - Country:US
Mailing Address - Phone:248-951-2296
Mailing Address - Fax:248-951-2315
Practice Address - Street 1:20905 GREENFIELD RD
Practice Address - Street 2:SUITE 608
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075-5360
Practice Address - Country:US
Practice Address - Phone:248-951-2296
Practice Address - Fax:248-951-2315
Is Sole Proprietor?:No
Enumeration Date:2006-11-16
Last Update Date:2016-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301084828207RA0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RA0401XAllopathic & Osteopathic PhysiciansInternal MedicineAddiction Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI5176830Medicaid
MI080F373970OtherBC
MI1106362902OtherBLUE CROSS BLUE SHIELD
MI1106362902OtherBLUE CROSS BLUE SHIELD
I35023Medicare UPIN
MIOM59880014Medicare ID - Type Unspecified