Individual
DR. OLUSANJO OLAOLUWA ADEOYE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD, MBA
Contact information
Practice address
4100 LAKE DR SE, SUITE 300, GRAND RAPIDS, MI 49546-8292
(616) 267-8860
(616) 267-8442
Mailing address
100 MICHIGAN ST NE, MC 845, GRAND RAPIDS, MI 49503-2560
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
4301104001
MI
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
4301104001
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1477716348
—
MI
Enumeration date
07/09/2008
Last updated
02/08/2017
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