Healthcare Provider Details

I. General information

NPI: 1265166227
Provider Name (Legal Business Name): BABAJIDE ADEWUMI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/14/2022
Last Update Date: 07/14/2022
Certification Date: 07/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

246 MIDDLETON PL
GRAYSON GA
30017-4116
US

IV. Provider business mailing address

246 MIDDLETON PL
GRAYSON GA
30017-4116
US

V. Phone/Fax

Practice location:
  • Phone: 706-372-0453
  • Fax:
Mailing address:
  • Phone: 706-372-0453
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246YC3301X
TaxonomyHospital Based Coding Specialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: