Provider Demographics
NPI:1962129643
Name:ADEOLA, IDOWU
Entity type:Individual
Prefix:
First Name:IDOWU
Middle Name:
Last Name:ADEOLA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3221 OAK RD APT WEST
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44118-1849
Mailing Address - Country:US
Mailing Address - Phone:410-917-1009
Mailing Address - Fax:
Practice Address - Street 1:3221 OAK RD APT WEST
Practice Address - Street 2:
Practice Address - City:CLEVELAND HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44118-1849
Practice Address - Country:US
Practice Address - Phone:410-917-1009
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-24
Last Update Date:2022-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376J00000XNursing Service Related ProvidersHomemakerGroup - Multi-Specialty