Provider Demographics
NPI:1780436428
Name:GBADAMOSI, AYOMIDE (MD)
Entity type:Individual
Prefix:DR
First Name:AYOMIDE
Middle Name:
Last Name:GBADAMOSI
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 1:2001 WEST 86TH STREET
Mailing Address - Street 2:ASCENSION ST VINCENT
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46260
Mailing Address - Country:US
Mailing Address - Phone:317-338-6089
Mailing Address - Fax:
Practice Address - Street 1:2001 WEST 86TH STREET
Practice Address - Street 2:ASCENSION ST VINCENT
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46260
Practice Address - Country:US
Practice Address - Phone:317-338-6089
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-04
Last Update Date:2024-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program