MEDICARE: ABIODUN BENJAMIN IDOWU MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	MD489836	PA

General Provider Information

NPI Number	:	1558097980
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ABIODUN BENJAMIN IDOWU MD

Provider Business Mailing Address
First Line	:	5501 OLD YORK RD
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19141-3018
Country	:	US
Telephone Number	:	215-456-6940
Fax Number	:

Provider Business Practice Location Address
First Line	:	5501 OLD YORK RD
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19141-3018
Country	:	US
Telephone Number	:	215-456-7890
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/27/2022
Last Update Date	:	03/09/2026

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