Healthcare Provider Details

I. General information

NPI: 1164564084
Provider Name (Legal Business Name): ANTHONY A ADELEYE M. D., P. C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/14/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20905 GREENFIELD RD STE. 702
SOUTHFIELD MI
48075-5360
US

IV. Provider business mailing address

20905 GREENFIELD RD STE. 702
SOUTHFIELD MI
48075-5360
US

V. Phone/Fax

Practice location:
  • Phone: 248-569-6700
  • Fax: 248-569-6706
Mailing address:
  • Phone: 248-569-6700
  • Fax: 248-569-6706

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number4301404448
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number4301404448
License Number StateMI

VIII. Authorized Official

Name: DR. ANTHONY A ADELEYE
Title or Position: PRESIDENT
Credential: M. D.
Phone: 248-569-6700