Provider Demographics
NPI:1811912033
Name:ADEROJU, ELIZABETH (MD)
Entity type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:
Last Name:ADEROJU
Suffix:
Gender:F
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:HWY 321 BYPASS
Mailing Address - Street 2:PALMETTO FAMILY PRIMARY HEALTHCARE
Mailing Address - City:WINNISBORO
Mailing Address - State:SC
Mailing Address - Zip Code:29180
Mailing Address - Country:US
Mailing Address - Phone:803-635-1052
Mailing Address - Fax:803-635-2297
Practice Address - Street 1:4220 N ROXBORO ST
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27704-1826
Practice Address - Country:US
Practice Address - Phone:919-471-1518
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2007-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC26807207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD372030Medicaid
SC372043Medicaid
SC372073Medicaid
SC372030Medicaid
SD372030Medicaid
UT43182Medicare PIN
UT421892Medicare PIN
SC372043Medicaid
UT421841Medicare PIN
NC2045939Medicare PIN