Adetola Samson Adebola, MD
Individual provider Active NPI Internal Medicine Physician · Corvallis, OR
NPI 1124602958 · NPPES record last updated May 7, 2021
Key facts
- NPI
- 1124602958
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- PG205256 (OR)
- Practice address
- 3600 NW Samaritan Dr
Corvallis, OR 97330-3737 - Phone
- (541) 768-4906
- NPI assigned
- May 7, 2021
- Sex
- Male
- Sole proprietor
- No
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
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | PG205256 | OR | Yes |
Addresses
Primary practice location
3600 NW Samaritan Dr
Corvallis, OR 97330-3737
Mailing address
3600 NW Samaritan Dr
Corvallis, OR 97330-3737
Phone (541) 768-4906
Other providers in Corvallis, OR
- Martha F Adams
- Tifen Adams
- Traci Adams
- Prathyush Sai Adapa
- Kareem A Addassi
- Bikash Adhikari
- Phyllis E Adjei
- Benjamin Andrew Adler
- Darcy Adsit
- Advanced Disability Services, Inc
All providers in Corvallis, OR · Internal Medicine Physician in Oregon
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 7, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.