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Individual

JENNIFER OLUYEMISI ADEGHATE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD, PHD

Contact information

Practice address
925 N 87TH ST, MILWAUKEE, WI 53226-4812
(414) 955-2020
Mailing address
925 N 87TH ST FL 4, MILWAUKEE, WI 53226-4812
(414) 955-2020

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
317267
NY
207WX0107X
Retina Specialist (Ophthalmology) Physician
Primary
83991-20
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100284234
WI
Enumeration date
04/04/2018
Last updated
10/01/2024
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