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General NPI Number Information
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NPI Number | 1649153917
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Entity Type | Organization
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Legal Business Name | ADANNA IKEDILO MD INC
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Dates
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Enumeration Date | 07/25/2025
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Last Update Date | 07/25/2025
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Provider Practice Location Address
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Address Line | 1865 E ALLUVIAL AVE STE 102
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City | FRESNO
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State | CA
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Zip | 93720-3855
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Country | US
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Telephone | 559-981-2612
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Fax |
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Provider Business Mailing Address
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Address Line | 777 E SHEPHERD AVE
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City | FRESNO
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State | CA
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Zip | 93720-1760
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Country | US
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Telephone | 559-712-0392
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | ADANNA IKEDILO
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Credential | MD
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Telephone | 559-712-0392
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number |
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License Number State |
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