Provider Demographics
NPI:1598261752
Name:APETUJE, MODUPE DEBBIE ADEDOYIN (DPM)
Entity Type:Individual
Prefix:DR
First Name:MODUPE
Middle Name:DEBBIE ADEDOYIN
Last Name:APETUJE
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3140 LEGACY DR STE 330
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-9383
Mailing Address - Country:US
Mailing Address - Phone:202-730-5102
Mailing Address - Fax:
Practice Address - Street 1:3140 LEGACY DR STE 330
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-9383
Practice Address - Country:US
Practice Address - Phone:972-864-7353
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-04
Last Update Date:2023-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
TX3187213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program