Provider Demographics
NPI:1326910118
Name:ADEBAYO, ADEKOLA
Entity type:Individual
Prefix:
First Name:ADEKOLA
Middle Name:
Last Name:ADEBAYO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10008 ERION CT
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20721-2843
Mailing Address - Country:US
Mailing Address - Phone:240-618-4917
Mailing Address - Fax:
Practice Address - Street 1:215 BROADUS ST
Practice Address - Street 2:
Practice Address - City:STURGIS
Practice Address - State:MI
Practice Address - Zip Code:49091-1384
Practice Address - Country:US
Practice Address - Phone:877-659-4500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-22
Last Update Date:2025-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant