Temitope Elizabeth Adebayo, DPM

Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Portland, OR

NPI 1043079411 · NPPES record last updated Mar 18, 2024

Key facts

NPI
1043079411
Entity type
Individual (NPI type 1)
Primary specialty
Student in an Organized Health Care Education/Training Program 390200000X
Practice address
1015 NW 22ND Ave
Portland, OR 97210-3025
Phone
(503) 413-8401
Fax
(503) 413-7361
NPI assigned
Mar 18, 2024
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20240521001244 OR Order and Referring Only - Podiatry
Practitioner - Podiatry
4082056163

National Provider Directory

Medicare enrollment (NPD)
Yes

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Yes

Addresses

Primary practice location

1015 NW 22ND Ave
Portland, OR 97210-3025

Mailing address

5008 Tura St
Raleigh, NC 27610-7179
Phone (667) 214-5979

Other providers in Portland, OR

All providers in Portland, OR · Student in an Organized Health Care Education/Training Program in Oregon

Sources for this page

Verify at the official NPI Registry.