Healthcare Provider Details

I. General information

NPI: 1720738743
Provider Name (Legal Business Name): ADERONKE F GBADEBO MD, MPH, MS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2022
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

WUSM PEDS, 1 CHILDRENS PL MSC 8116-0043-08
SAINT LOUIS MO
63110
US

IV. Provider business mailing address

WUSM PEDS, 1 CHILDRENS PL MSC 8116-0043-08
SAINT LOUIS MO
63110
US

V. Phone/Fax

Practice location:
  • Phone: 314-454-4826
  • Fax: 314-454-4633
Mailing address:
  • Phone: 314-454-4826
  • Fax: 314-454-4633

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number2026027323
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number79303
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: