Individual
DR. GBENGA ADEYEMI ADEYEYE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
9000 FRANKLIN SQUARE DR, BALTIMORE, MD 21237-3901
(757) 619-2749
Mailing address
3400 RACHEL TER APT 18, PINE BROOK, NJ 07058-9360
(757) 343-1829
Taxonomy
Speciality
Code
Description
License number
State
2085R0204X
Vascular & Interventional Radiology Physician
Primary
330954
NY
363A00000X
Physician Assistant
0110004213
VA
363A00000X
Physician Assistant
C05998
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10106951P
OPTIMA HEALTH PLAN
VA
01
—
10112734P
SENTARA HEALTH PLAN
VA
01
—
1053654814
TRICARE PRIME NETWORK
VA
05
—
1053654814
—
VA
01
—
178PY
BCBSNC
VA
01
—
493474
BCBSVA
VA
01
—
P01192419
RAILROAD MEDICARE
VA
Enumeration date
03/30/2013
Last updated
04/03/2025
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