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General NPI Number Information
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NPI Number | 1629125679
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Entity Type | Individual
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Provider Name | OLUBUNMI ADEGBOYEGA MD
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Gender | Male
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Dates
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Enumeration Date | 01/04/2007
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Last Update Date | 03/10/2020
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Provider Practice Location Address
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Address Line | 801 EASTERN BYPASS
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City | RICHMOND
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State | KY
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Zip | 40476
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Country | US
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Telephone | 859-625-3497
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Fax | 859-625-3307
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Provider Business Mailing Address
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Address Line | 1 MCBRIDE AND SON CENTER DR STE 150
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City | CHESTERFIELD
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State | MO
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Zip | 63005-1425
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 40714
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 01083255A
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License Number State | IN
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Taxonomy #3
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 40714
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License Number State | KY
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