Provider Demographics
NPI:1376227413
Name:DADA, OLADIPUPO AYODELE
Entity Type:Individual
Prefix:DR
First Name:OLADIPUPO
Middle Name:AYODELE
Last Name:DADA
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 1:30 MEADOW VALLEY CT
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:GA
Mailing Address - Zip Code:31820-4393
Mailing Address - Country:US
Mailing Address - Phone:719-310-8283
Mailing Address - Fax:
Practice Address - Street 1:1100 CIRCLE 75 PKWY SE STE 1400
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30339-3067
Practice Address - Country:US
Practice Address - Phone:850-622-0842
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-09
Last Update Date:2023-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist