Individual
ADEBAYO BADEMOSI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7905 CALUMET AVE, MUNSTER, IN 46321-2549
(219) 836-5800
(219) 836-5030
Mailing address
1040 SIERRA DR STE 400, GREENWOOD, IN 46143-7241
(317) 528-4800
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
036-101658
IL
207Q00000X
Family Medicine Physician
Primary
01066470A
IN
207Q00000X
Family Medicine Physician
036101658
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03610165801
—
IL
05
—
300010994
—
IN
Enumeration date
08/25/2006
Last updated
03/13/2021
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