MEDICARE: ABIMBOLA A FADAIRO-AZINGE MBBS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RR0500X	Rheumatology Physician	35.154489	OH

General Provider Information

NPI Number	:	1356804066
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ABIMBOLA A FADAIRO-AZINGE MBBS

Provider Business Mailing Address
First Line	:	700 ACKERMAN RD STE 2120
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43202-1559
Country	:	US
Telephone Number	:	614-293-4837
Fax Number	:	614-293-3125

Provider Business Practice Location Address
First Line	:	3691 RIDGE MILL DR
Second Line	:
City	:	HILLIARD
State	:	OH
Zip	:	43026-7752
Country	:	US
Telephone Number	:	614-293-4837
Fax Number	:	614-293-3125

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/09/2019
Last Update Date	:	06/04/2026

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