MEDICARE: OPEYEMI ELIZABETH ADEWUMI

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	133V00000X	Registered Dietitian	86209569	AL

General Provider Information

NPI Number	:	1497620678
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	OPEYEMI ELIZABETH ADEWUMI

Provider Business Mailing Address
First Line	:	3050 KELLY CIR APT F
Second Line	:
City	:	MONTGOMERY
State	:	AL
Zip	:	36116-5228
Country	:	US
Telephone Number	:	334-420-5001
Fax Number	:	334-356-1487

Provider Business Practice Location Address
First Line	:	2905 E SOUTH BLVD
Second Line	:
City	:	MONTGOMERY
State	:	AL
Zip	:	36116-2501
Country	:	US
Telephone Number	:	334-288-0009
Fax Number	:	334-356-1487

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

Provider Enumeration Date	:	10/08/2025
Last Update Date	:	10/24/2025

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