Healthcare Provider Details

I. General information

NPI: 1467015024
Provider Name (Legal Business Name): VICTORIA ADEDOJA ADEWALE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/19/2019
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2729 BLAIR MILL RD STE C
WILLOW GROVE PA
19090-1042
US

IV. Provider business mailing address

2729 BLAIR MILL RD STE C
WILLOW GROVE PA
19090-1042
US

V. Phone/Fax

Practice location:
  • Phone: 215-443-0660
  • Fax: 215-443-8442
Mailing address:
  • Phone: 215-443-0660
  • Fax: 215-443-8442

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberMD493747
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: