Provider Demographics
NPI:1477296242
Name:OLABUMUYI, ADENIYI ADEDAYO (MBBS)
Entity type:Individual
Prefix:
First Name:ADENIYI
Middle Name:ADEDAYO
Last Name:OLABUMUYI
Suffix:
Gender:M
Credentials:MBBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:66 WINTERGREEN TRL
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77382
Mailing Address - Country:US
Mailing Address - Phone:469-837-9512
Mailing Address - Fax:
Practice Address - Street 1:760 BROADWAY
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11206
Practice Address - Country:US
Practice Address - Phone:718-963-8752
Practice Address - Fax:718-953-8753
Is Sole Proprietor?:No
Enumeration Date:2022-04-19
Last Update Date:2022-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program