Provider Demographics
NPI:1588272595
Name:ADE & MO LLC
Entity type:Organization
Organization Name:ADE & MO LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/ PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ADESANMI
Authorized Official - Middle Name:ABEL
Authorized Official - Last Name:OJO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:336-926-0417
Mailing Address - Street 1:917 SANDSTONE DR
Mailing Address - Street 2:
Mailing Address - City:WYOMISSING
Mailing Address - State:PA
Mailing Address - Zip Code:19610-6816
Mailing Address - Country:US
Mailing Address - Phone:336-926-0417
Mailing Address - Fax:
Practice Address - Street 1:589 BETHLEHEM PIKE STE 200
Practice Address - Street 2:
Practice Address - City:MONTGOMERYVILLE
Practice Address - State:PA
Practice Address - Zip Code:18936-9744
Practice Address - Country:US
Practice Address - Phone:484-447-6121
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-15
Last Update Date:2020-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty