Provider Demographics
NPI:1922747914
Name:AJOSE, IDOWU AFOLARIN (MD)
Entity Type:Individual
Prefix:DR
First Name:IDOWU
Middle Name:AFOLARIN
Last Name:AJOSE
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 1:420 DELAWARE STREET, UNIVERSITY OF MINNESOTA
Mailing Address - Street 2:SE, MMC 284
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55455
Mailing Address - Country:US
Mailing Address - Phone:612-625-9100
Mailing Address - Fax:612-273-8383
Practice Address - Street 1:420 DELAWARE STREET, UNIVERSITY OF MINNESOTA
Practice Address - Street 2:SE, MMC 284
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55455
Practice Address - Country:US
Practice Address - Phone:612-625-9100
Practice Address - Fax:612-273-8383
Is Sole Proprietor?:No
Enumeration Date:2022-05-31
Last Update Date:2023-03-23
Deactivation Date:2023-02-27
Deactivation Code:
Reactivation Date:2023-03-23
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program