Healthcare Provider Details

I. General information

NPI: 1215260930
Provider Name (Legal Business Name): ADEDOYIN O ADETORO M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/14/2009
Last Update Date: 07/11/2026
Certification Date: 07/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4200 REGENT ST STE 200
COLUMBUS OH
43219-6229
US

IV. Provider business mailing address

7652 SAWMILL RD. PMB 334
DUBLIN OH
43016-9296
US

V. Phone/Fax

Practice location:
  • Phone: 973-634-6582
  • Fax:
Mailing address:
  • Phone: 614-412-2888
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number35.098955
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: