MEDICARE: IDOWU ADEOLA

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	376J00000X	Homemaker

General Provider Information

NPI Number	:	1962129643
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	IDOWU ADEOLA

Provider Business Mailing Address
First Line	:	3221 OAK RD APT WEST
Second Line	:
City	:	CLEVELAND HEIGHTS
State	:	OH
Zip	:	44118-1849
Country	:	US
Telephone Number	:	410-917-1009
Fax Number	:

Provider Business Practice Location Address
First Line	:	3221 OAK RD APT WEST
Second Line	:
City	:	CLEVELAND HEIGHTS
State	:	OH
Zip	:	44118-1849
Country	:	US
Telephone Number	:	410-917-1009
Fax Number	:

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

Provider Enumeration Date	:	10/24/2022
Last Update Date	:	10/24/2022

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Directions to “ IDOWU ADEOLA ” Practice Location

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