Provider Demographics
NPI:1811743479
Name:ADEOLA, ADEBAYO
Entity type:Individual
Prefix:
First Name:ADEBAYO
Middle Name:
Last Name:ADEOLA
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 1:5754 THORTON ST APT 103
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43081-7196
Mailing Address - Country:US
Mailing Address - Phone:614-256-1602
Mailing Address - Fax:
Practice Address - Street 1:5754 THORTON ST APT 103
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43081-7196
Practice Address - Country:US
Practice Address - Phone:614-256-1602
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-25
Last Update Date:2024-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker