Healthcare Provider Details

I. General information

NPI: 1487495909
Provider Name (Legal Business Name): ADEFISAYO AYOADE ADEKANMBI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/06/2024
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 PEPPERELL EAST ALABAMA MEDICAL CENTER
OPELIKA AL
36801
US

IV. Provider business mailing address

2000 PEPPERELL EAST ALABAMA MEDICAL CENTER
OPELIKA AL
36801
US

V. Phone/Fax

Practice location:
  • Phone: 617-638-8994
  • Fax: 334-364-3301
Mailing address:
  • Phone: 334-364-3300
  • Fax: 334-364-3301

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: