Provider Demographics
NPI:1700049939
Name:ADENAIKE, MICHAEL BABATUNDE (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:BABATUNDE
Last Name:ADENAIKE
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:PO BOX 829641
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19182-9641
Mailing Address - Country:US
Mailing Address - Phone:215-933-0259
Mailing Address - Fax:215-933-3672
Practice Address - Street 1:315 W STATE ST
Practice Address - Street 2:
Practice Address - City:DOYLESTOWN
Practice Address - State:PA
Practice Address - Zip Code:18901-3525
Practice Address - Country:US
Practice Address - Phone:215-345-1900
Practice Address - Fax:215-345-4579
Is Sole Proprietor?:No
Enumeration Date:2008-07-08
Last Update Date:2023-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD435337207R00000X, 207RC0000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA50118268OtherCAPITAL BLUE CROSS
PAUSE NPIOtherINTERGROUP
PAUSE NPIOtherHIGHMARK BLUE SHIELD
PA102843139Medicaid
PA50118268OtherCAPITAL BLUE CROSS
PA291957G0DMedicare PIN