MEDICARE: DR. TEMIDAYO A ADELEKUN MD

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	207R00000X	Internal Medicine Physician	200001048	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1962497537
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TEMIDAYO A ADELEKUN MD

Provider Business Mailing Address
First Line	:	502 W KING ST
Second Line	:	LL#20
City	:	KINGS MOUNTAIN
State	:	NC
Zip	:	28086-3362
Country	:	US
Telephone Number	:	704-730-8461
Fax Number	:	704-730-8349

Provider Business Practice Location Address
First Line	:	502 W KING ST
Second Line	:	LL#20
City	:	KINGS MOUNTAIN
State	:	NC
Zip	:	28086-3362
Country	:	US
Telephone Number	:	704-730-8461
Fax Number	:	704-730-8349

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

Provider Enumeration Date	:	09/20/2005
Last Update Date	:	08/24/2011

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