Healthcare Provider Details

I. General information

NPI: 1871446286
Provider Name (Legal Business Name): ANEW REGENERATIVE MEDICINE SPECIALISTS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/16/2026
Last Update Date: 02/16/2026
Certification Date: 02/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28544 ORCHARD LAKE RD
FARMINGTON HILLS MI
48334-2909
US

IV. Provider business mailing address

28544 ORCHARD LAKE RD
FARMINGTON HILLS MI
48334-2909
US

V. Phone/Fax

Practice location:
  • Phone: 248-797-2795
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081S0010X
TaxonomySports Medicine (Physical Medicine & Rehabilitation) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. ABIOLA DIANNE ADISA-OBAYAN
Title or Position: CEO/MEDICAL DIRECTOR
Credential: MD
Phone: 248-797-2795