Provider Demographics
NPI:1467958579
Name:OLADEJI, PHILIP OLUWAKAYODE (MD)
Entity Type:Individual
Prefix:
First Name:PHILIP
Middle Name:OLUWAKAYODE
Last Name:OLADEJI
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 1:57 EXECUTIVE PARK S STE 120
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30329-2248
Mailing Address - Country:US
Mailing Address - Phone:404-778-1567
Mailing Address - Fax:
Practice Address - Street 1:9500 EUCLID AVE # A41
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44195-0001
Practice Address - Country:US
Practice Address - Phone:216-445-3834
Practice Address - Fax:216-445-6255
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-05
Last Update Date:2023-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
OH35.147505207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program