Provider Demographics
NPI:1912637604
Name:GADJIGO, AMADOU
Entity Type:Individual
Prefix:
First Name:AMADOU
Middle Name:
Last Name:GADJIGO
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 1:3266 KADY LN
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43232-7454
Mailing Address - Country:US
Mailing Address - Phone:614-843-5449
Mailing Address - Fax:
Practice Address - Street 1:3266 KADY LN
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43232-7454
Practice Address - Country:US
Practice Address - Phone:614-843-5449
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-15
Last Update Date:2022-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty