Provider Demographics
NPI:1306089701
Name:AFOLABI, ADEBIMPE O (DO)
Entity type:Individual
Prefix:DR
First Name:ADEBIMPE
Middle Name:O
Last Name:AFOLABI
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7030 HORROCKS ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19149-1720
Mailing Address - Country:US
Mailing Address - Phone:267-288-7754
Mailing Address - Fax:
Practice Address - Street 1:1500 HIGHLANDS DR
Practice Address - Street 2:
Practice Address - City:LITITZ
Practice Address - State:PA
Practice Address - Zip Code:17543-7694
Practice Address - Country:US
Practice Address - Phone:717-625-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-14
Last Update Date:2009-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS 014618207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine