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General NPI Number Information
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NPI Number | 1689834269
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Entity Type | Individual
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Provider Name | YETUNDE A. ADESANYA M.D
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Gender | Female
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Dates
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Enumeration Date | 06/17/2008
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Last Update Date | 11/22/2024
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Provider Practice Location Address
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Address Line | 3115 BORDEAUX PARK DR
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City | FAYETTEVILLE
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State | NC
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Zip | 28306-2894
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Country | US
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Telephone | 910-307-7337
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Fax | 910-323-4620
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Provider Business Mailing Address
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Address Line | 5617 RAMSEY ST
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City | FAYETTEVILLE
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State | NC
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Zip | 28311-1423
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Country | US
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Telephone | 910-483-7337
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Fax | 910-483-0648
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 2008-00941
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License Number State | NC
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