Provider Demographics
NPI:1689834269
Name:ADESANYA, YETUNDE ADEOLA (MD)
Entity Type:Individual
Prefix:DR
First Name:YETUNDE
Middle Name:ADEOLA
Last Name:ADESANYA
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:PO BOX 647
Mailing Address - Street 2:
Mailing Address - City:HOPE MILLS
Mailing Address - State:NC
Mailing Address - Zip Code:28348-0647
Mailing Address - Country:US
Mailing Address - Phone:910-483-7337
Mailing Address - Fax:910-483-0648
Practice Address - Street 1:3115 BORDEAUX PARK DR
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28306-2894
Practice Address - Country:US
Practice Address - Phone:910-307-7337
Practice Address - Fax:910-323-4620
Is Sole Proprietor?:No
Enumeration Date:2008-06-17
Last Update Date:2016-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2008-00941208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1045067OtherWELLPATH
NC217771OtherMEDCOST, LLC
NCFH1101555OtherFIRST CAROLINA CARE
NC1689834269OtherHEALTHNET FEDERAL SERVICES
NC4015906OtherCOVENTRY NATIONAL - COVENTRY PPO
NC12735847OtherPHCS-MULTIPLAN
NC1689834269OtherDOCTORS DIRECT
NC1689834269Medicaid
NC9297402OtherAETNA
NC1045067OtherCOVENTRY OF THE CAROLINAS
NC1689834269OtherHUMANA
NC3038401OtherUNITED HEALTHCARE
NC4101857OtherCIGNA GREATWEST
NC1603JOtherBCBS OF NC
NC1689834269OtherHEALTHSMART