Individual
JOHN A ADENIYI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D., F.A.C.S.
Contact information
Practice address
527 MEDICAL PARK DR STE 501, BRIDGEPORT, WV 26330
(304) 842-3993
(304) 842-4083
Mailing address
PO BOX 890, BRIDGEPORT, WV 26330-0890
(304) 842-3993
(304) 842-4083
Taxonomy
Speciality
Code
Description
License number
State
2085R0204X
Vascular & Interventional Radiology Physician
WV21293
WV
2086S0129X
Vascular Surgery Physician
Primary
WV21293
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001719007
BCBS
WV
05
—
3810000654
—
WV
01
—
P00093109
RR MC
WV
Enumeration date
10/24/2006
Last updated
04/06/2022
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