Provider Demographics
NPI:1184232274
Name:ADADE, FRED OBURONI
Entity Type:Individual
Prefix:
First Name:FRED
Middle Name:OBURONI
Last Name:ADADE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2600 OAKSTONE DR STE 14
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43231-7613
Mailing Address - Country:US
Mailing Address - Phone:614-747-6973
Mailing Address - Fax:
Practice Address - Street 1:2600 OAKSTONE DR STE 14
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43231-7613
Practice Address - Country:US
Practice Address - Phone:614-747-6973
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-15
Last Update Date:2020-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)