Provider Demographics
NPI:1730136615
Name:ADEBAYO, AYODELE L (MD, MPH)
Entity Type:Individual
Prefix:
First Name:AYODELE
Middle Name:L
Last Name:ADEBAYO
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6105 CENTER HILL AVE
Mailing Address - Street 2:FE-A4
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45224-1705
Mailing Address - Country:US
Mailing Address - Phone:513-634-1622
Mailing Address - Fax:513-386-1807
Practice Address - Street 1:6105 CENTER HILL AVE
Practice Address - Street 2:FE-A4
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45224-1705
Practice Address - Country:US
Practice Address - Phone:513-634-1622
Practice Address - Fax:513-386-1807
Is Sole Proprietor?:No
Enumeration Date:2006-05-27
Last Update Date:2011-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35084960207R00000X
OH35.0849602083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2536018Medicaid
I23977Medicare UPIN
OH2536018Medicaid