Omotola Michael Adesina, M.D.

Individual provider Active NPI Family Medicine Physician · Lansing, MI

NPI 1275217622 · NPPES record last updated Dec 15, 2023

Key facts

NPI
1275217622
Entity type
Individual (NPI type 1)
Primary specialty
Family Medicine Physician 207Q00000X
License
4351050593 (MI)
Practice address
Sparrow Health Systems 1215 E Michigan Ave
Lansing, MI 18912
Phone
(517) 364-5710
NPI assigned
Jun 14, 2023
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)
No
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4351050593MIMDFamily Medicine Physician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 4351050593 MI Yes

Addresses

Primary practice location

Sparrow Health Systems 1215 E Michigan Ave
Lansing, MI 18912

Mailing address

1200 E Michigan Ave
Suite 245
Lansing, MI 48912

Other providers in Lansing, MI

All providers in Lansing, MI · Family Medicine Physician in Michigan

Sources for this page

Verify at the official NPI Registry.