Provider Demographics
NPI:1699794396
Name:MOORE, ADENIKE MOJISOLA (DO)
Entity type:Individual
Prefix:MRS
First Name:ADENIKE
Middle Name:MOJISOLA
Last Name:MOORE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:MS
Other - First Name:ADENIKE
Other - Middle Name:MOJISOLA
Other - Last Name:LONG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:1101 SUMMIT RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45237-2621
Mailing Address - Country:US
Mailing Address - Phone:513-948-3600
Mailing Address - Fax:513-948-8631
Practice Address - Street 1:1101 SUMMIT RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45237-2621
Practice Address - Country:US
Practice Address - Phone:513-948-3600
Practice Address - Fax:513-948-8631
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2015-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPENDING2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry