Physician Compare National (NPI:1942532528)

HEALTHCARE PROVIDER: ADETUNJI A ADEJUMO MD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1942532528
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	9638294986
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20100910000295
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	ADEJUMO
	Individual professional last name
Provider First Name	ADETUNJI
	Individual professional first name
Provider Middle Name	A
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	1997
	Individual professional's medical school graduation year
Primary Specialty	INFECTIOUS DISEASE
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	333 N PETERS AVE
	Group Practice or individual's line 1 address
City	FOND DU LAC
	Group Practice or individual's city
State	WI
	Group Practice or individual's state
Zip Code	549358257
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	520088
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	ST AGNES HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	520160
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	THEDACARE REGIONAL MEDICAL CENTER - APPLETON INC
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	520107
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	HOLY FAMILY MEMORIAL
	Legal business name of hospital where individual professional provides service 3
Hospital Affiliation CCN 4	520045
	Medicare CCN of hospital where individual professional provides service 4
Hospital Affiliation LBN 4	THEDA CLARK MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 4
Professional Accepts Medicare Assignment	Y