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General NPI Number Information
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NPI Number | 1346115565
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Entity Type | Individual
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Provider Name | PAUL AJIBOLA AFOLAYAN
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Gender | Male
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Dates
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Enumeration Date | 10/07/2025
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Last Update Date | 10/07/2025
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Provider Practice Location Address
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Address Line | 4425 REDHAVEN DR
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City | INDIANAPOLIS
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State | IN
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Zip | 46235-1052
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Country | US
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Telephone | 317-631-1012
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Fax |
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Provider Business Mailing Address
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Address Line | 3926 BONN DR
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City | INDIANAPOLIS
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State | IN
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Zip | 46228-6790
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Country | US
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Telephone | 317-361-1012
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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 | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number |
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License Number State | IN
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