Healthcare Provider Details

I. General information

NPI: 1407057292
Provider Name (Legal Business Name): ESTHER O AKINYEMI M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ESTHER O ADEDIBU

II. Dates (important events)

Enumeration Date: 05/30/2007
Last Update Date: 05/19/2025
Certification Date: 05/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2799 W GRAND BOULEVARD NULL
DETROIT MI
48267-0001
US

IV. Provider business mailing address

1 FORD PL # 3A
DETROIT MI
48202-3450
US

V. Phone/Fax

Practice location:
  • Phone: 313-916-2000
  • Fax:
Mailing address:
  • Phone: 313-461-9670
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number4301082015
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code2084P0805X
TaxonomyGeriatric Psychiatry Physician
License Number4301082015
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: