Provider Demographics
NPI:1689134256
Name:ADEYANJU, OLUWAKEMI ELIZABETH (MD)
Entity Type:Individual
Prefix:
First Name:OLUWAKEMI
Middle Name:ELIZABETH
Last Name:ADEYANJU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:OLUWAKEMI
Other - Middle Name:ELIZABETH
Other - Last Name:BANKOLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MBCHB
Mailing Address - Street 1:1514 JEFFERSON HWY
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70121-2429
Mailing Address - Country:US
Mailing Address - Phone:504-842-4021
Mailing Address - Fax:
Practice Address - Street 1:1514 JEFFERSON HWY
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70121-2429
Practice Address - Country:US
Practice Address - Phone:504-842-4021
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-20
Last Update Date:2022-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA330440207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine