Provider Demographics
NPI:1083898621
Name:MAKINDE, AYODEJI C (MD)
Entity type:Individual
Prefix:MR
First Name:AYODEJI
Middle Name:C
Last Name:MAKINDE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1575 CHATTANOOGA AVE
Mailing Address - Street 2:STE 1
Mailing Address - City:DALTON
Mailing Address - State:GA
Mailing Address - Zip Code:30721
Mailing Address - Country:US
Mailing Address - Phone:706-876-2130
Mailing Address - Fax:706-876-2168
Practice Address - Street 1:1575 CHATTANOOGA AVE
Practice Address - Street 2:STE 1
Practice Address - City:DALTON
Practice Address - State:GA
Practice Address - Zip Code:30721
Practice Address - Country:US
Practice Address - Phone:706-876-2130
Practice Address - Fax:706-876-2168
Is Sole Proprietor?:No
Enumeration Date:2007-12-18
Last Update Date:2011-03-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA059828208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics