Healthcare Provider Details

I. General information

NPI: 1992669709
Provider Name (Legal Business Name): ADEBOWALE A ADEDIPE MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/15/2025
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11201 SHAKER BLVD STE 338
CLEVELAND OH
44104-3871
US

IV. Provider business mailing address

11201 SHAKER BLVD STE 338
CLEVELAND OH
44104-3871
US

V. Phone/Fax

Practice location:
  • Phone: 216-368-7910
  • Fax: 321-636-8791
Mailing address:
  • Phone: 216-368-7910
  • Fax: 216-368-7915

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. ADEBOWALE ADEJAYI ADEDIPE
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 216-392-8501