MEDICARE: DR. JOYCE ADELEKE O.D.

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	152W00000X	Optometrist	1885	NC

General Provider Information

NPI Number	:	1700892031
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOYCE ADELEKE O.D.

Provider Business Mailing Address
First Line	:	10030 EDISON SQUARE DR NW
Second Line	:	SUITE 201
City	:	CONCORD
State	:	NC
Zip	:	28027-8308
Country	:	US
Telephone Number	:	704-766-1130
Fax Number	:	704-766-1130

Provider Business Practice Location Address
First Line	:	10030 EDISON SQUARE DR NW
Second Line	:	SUITE 201
City	:	CONCORD
State	:	NC
Zip	:	28027-8308
Country	:	US
Telephone Number	:	704-766-1130
Fax Number	:	704-766-1130

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

Provider Enumeration Date	:	07/31/2006
Last Update Date	:	08/19/2011

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