Provider Demographics
NPI:1801419155
Name:EKETUNDE, ADENIKE (MD,MPH)
Entity Type:Individual
Prefix:
First Name:ADENIKE
Middle Name:
Last Name:EKETUNDE
Suffix:
Gender:F
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 1:670 ALBANY ST
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02118-2646
Mailing Address - Country:US
Mailing Address - Phone:978-483-8854
Mailing Address - Fax:
Practice Address - Street 1:670 ALBANY ST STE 3
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02118-2653
Practice Address - Country:US
Practice Address - Phone:617-414-5314
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-21
Last Update Date:2022-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program