Provider Demographics
NPI:1821357112
Name:ADIKE, ABIMBOLA
Entity Type:Individual
Prefix:DR
First Name:ABIMBOLA
Middle Name:
Last Name:ADIKE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22180 OLYMPIC COLLEGE WAY NW STE 204
Mailing Address - Street 2:
Mailing Address - City:POULSBO
Mailing Address - State:WA
Mailing Address - Zip Code:98370-6664
Mailing Address - Country:US
Mailing Address - Phone:360-447-8951
Mailing Address - Fax:
Practice Address - Street 1:22180 OLYMPIC COLLEGE WAY NW STE 204
Practice Address - Street 2:
Practice Address - City:POULSBO
Practice Address - State:WA
Practice Address - Zip Code:98370-6664
Practice Address - Country:US
Practice Address - Phone:360-447-8951
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-08
Last Update Date:2022-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD60817922207RG0100X, 207RG0100X
AZ50324207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology