Provider Demographics
NPI:1194127076
Name:ADEWUMI, ADELEKE BENJAMIN
Entity type:Individual
Prefix:MR
First Name:ADELEKE
Middle Name:BENJAMIN
Last Name:ADEWUMI
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 1:4705 CARDINAL GROVE BLVD
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27616-2979
Mailing Address - Country:US
Mailing Address - Phone:614-772-1610
Mailing Address - Fax:
Practice Address - Street 1:4705 CARDINAL GROVE BLVD
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27616-2979
Practice Address - Country:US
Practice Address - Phone:614-772-1610
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-22
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC310214163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse