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Individual

ADEMOLA K ABIOSE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
125 E BROAD ST STE 305, ELYRIA, OH 44035-6447
(440) 414-9100
Mailing address
29325 HEALTH CAMPUS DR STE 3, WESTLAKE, OH 44145-8201
(440) 414-9400
(216) 201-5591

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
35096539
OH
207RC0000X
Cardiovascular Disease Physician
Primary
35096539
OH
207UN0901X
Nuclear Cardiology Physician
35096539
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3154321
OH
Enumeration date
11/08/2005
Last updated
01/11/2021
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