Adekoyejo B Adenuga, M.D.

Individual provider Active NPI Pediatrics Physician · Adrian, MI

NPI 1003066440 · NPPES record last updated Sep 23, 2008

Key facts

NPI
1003066440
Entity type
Individual (NPI type 1)
Primary specialty
Pediatrics Physician 208000000X
License
4301068655 (MI)
Practice address
901 Kimole LN
Suite B2
Adrian, MI 49221-1491
Phone
(517) 265-1981
Fax
(517) 263-1001
NPI assigned
Sep 23, 2008
Sex
Male
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Nuga Pediatrics Lenawee, PLLC Pediatrics Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 4301068655 MI Yes

Addresses

Primary practice location

901 Kimole LN
Suite B2
Adrian, MI 49221-1491

Mailing address

901 Kimole LN
Suite B2
Adrian, MI 49221-1491
Phone (517) 265-1981

Other identifiers

IdentifierTypeStateIssuer
101149OtherMIGREAT LAKES HEALTH PLAN
6862713OtherMICIGNA
03774OtherMIPARAMOUNT HEALTHCARE
5697OtherMIHEALTH PLAN OF MICHIGAN
7000339381OtherMIPRIORITY HEALTH CARE
0461056OtherMIBCBS
4843556MedicaidMI

Other providers in Adrian, MI

All providers in Adrian, MI · Pediatrics Physician in Michigan

Sources for this page

Verify at the official NPI Registry.