Provider Demographics
NPI:1245226612
Name:ADEDIJI, OLUYINKA (MD)
Entity type:Individual
Prefix:
First Name:OLUYINKA
Middle Name:
Last Name:ADEDIJI
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 1:215 WINTON M BLOUNT LOOP
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36117-3507
Mailing Address - Country:US
Mailing Address - Phone:334-239-9480
Mailing Address - Fax:334-239-7800
Practice Address - Street 1:215 WINTON M BLOUNT LOOP
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36117-3507
Practice Address - Country:US
Practice Address - Phone:334-239-9480
Practice Address - Fax:334-239-7800
Is Sole Proprietor?:No
Enumeration Date:2005-09-21
Last Update Date:2023-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL00245207R00000X
AL00024570207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51507337ADEOtherBCBS
AL630901073Medicaid
AL51515411ADEOtherBCBS
AL630910073Medicaid
AL51515410ADEOtherBCBS
AL630902073Medicaid
AL51515412ADEOtherBCBS
AL630906073Medicaid
AL630903073Medicaid
AL630908073Medicaid
AL630900073Medicaid
AL630900073Medicaid
AL630906073Medicaid