Provider Demographics
NPI:1013500206
Name:GLOBALMED LAB AND FORENSICS PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:GLOBALMED LAB AND FORENSICS PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BAMIDELE
Authorized Official - Middle Name:A
Authorized Official - Last Name:ADEAGBO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-646-2665
Mailing Address - Street 1:2901 OHIO BLVD STE 127
Mailing Address - Street 2:
Mailing Address - City:TERRE HAUTE
Mailing Address - State:IN
Mailing Address - Zip Code:47803-2239
Mailing Address - Country:US
Mailing Address - Phone:812-232-0021
Mailing Address - Fax:812-237-1494
Practice Address - Street 1:3901 S 7TH ST
Practice Address - Street 2:
Practice Address - City:TERRE HAUTE
Practice Address - State:IN
Practice Address - Zip Code:47802-5709
Practice Address - Country:US
Practice Address - Phone:812-232-0021
Practice Address - Fax:812-237-1494
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-18
Last Update Date:2021-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic PathologyGroup - Multi-Specialty