Provider Demographics
NPI:1639814213
Name:ADENIYI, ADEBOLA (MD)
Entity Type:Individual
Prefix:DR
First Name:ADEBOLA
Middle Name:
Last Name:ADENIYI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:708 SADDLEBACK CIR
Mailing Address - Street 2:
Mailing Address - City:BRIDGEPORT
Mailing Address - State:WV
Mailing Address - Zip Code:26330-9652
Mailing Address - Country:US
Mailing Address - Phone:203-414-2924
Mailing Address - Fax:
Practice Address - Street 1:300 PASTEUR DR DEPT STANFORD
Practice Address - Street 2:
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94305-2200
Practice Address - Country:US
Practice Address - Phone:650-723-5948
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-28
Last Update Date:2022-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program