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General NPI Number Information
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NPI Number | 1275762239
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Entity Type | Individual
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Provider Name | FOLASADE AJAYI M.D.
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Gender | Female
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Dates
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Enumeration Date | 07/10/2009
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Last Update Date | 04/02/2021
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Provider Practice Location Address
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Address Line | 263 FARMINGTON AVE
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City | FARMINGTON
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State | CT
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Zip | 06030
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Country | US
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Telephone | 860-679-2853
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Fax |
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Provider Business Mailing Address
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Address Line | 1513 CLEVELAND AVE BLDG 100
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City | EAST POINT
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State | GA
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Zip | 30344-6947
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 4301113696
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 4301113696
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License Number State | MI
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