Individual
DR. AMIDAT O ADEYEMI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1120 15TH ST, AUGUSTA, GA 30912-0004
(706) 721-2238
Mailing address
1120 15TH ST, AUGUSTA, GA 30912-0004
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
89199
GA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/25/2018
Last updated
07/19/2021
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