Healthcare Provider Details

I. General information

NPI: 1821921115
Provider Name (Legal Business Name): ALEFE ADIMASU
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/05/2026
Last Update Date: 06/05/2026
Certification Date: 06/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 HURLEY PLZ
FLINT MI
48503-5902
US

IV. Provider business mailing address

5450 WOODFIELD PKWY
GRAND BLANC MI
48439-9401
US

V. Phone/Fax

Practice location:
  • Phone: 734-925-1891
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208U00000X
TaxonomyClinical Pharmacology Physician
License Number5302038069
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: