Individual
MICHAEL SOLEDAYO FAGBAMIYE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CEO
Contact information
Practice address
6025 PEREGRINE BLVD, INDIANAPOLIS, IN 46228-1504
(317) 652-6420
Mailing address
6025 PEREGRINE BLVD, INDIANAPOLIS, IN 46228-1504
(317) 652-6420
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
25-018973-1
IN
3747A0650X
Attendant Care Provider
Primary
25-018973-1
IN
Other
Enumeration date
10/09/2025
Last updated
10/09/2025
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