Provider Demographics
NPI:1427289883
Name:ADEYEMO, ADEWUNMI (MD)
Entity type:Individual
Prefix:
First Name:ADEWUNMI
Middle Name:
Last Name:ADEYEMO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3106 S WAYNE RD
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:MI
Mailing Address - Zip Code:48184-1221
Mailing Address - Country:US
Mailing Address - Phone:734-722-6300
Mailing Address - Fax:
Practice Address - Street 1:3106 S WAYNE RD
Practice Address - Street 2:
Practice Address - City:WAYNE
Practice Address - State:MI
Practice Address - Zip Code:48184-1221
Practice Address - Country:US
Practice Address - Phone:734-722-6300
Practice Address - Fax:734-722-4815
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-04
Last Update Date:2020-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301095314208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery