Individual
DR. BAMIDELE A ADESUNLOYE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
600 CELEBRATE LIFE PKWY, NEWNAN, GA 30265-8001
(770) 400-6000
Mailing address
6845 RAMA DR, INDIANAPOLIS, IN 46219-1707
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
01071599A
IN
207RH0003X
Hematology & Oncology Physician
Primary
55545
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000853232
ANTHEM PROVIDER NUMBER
IN
05
—
201112810
—
IN
01
—
55545
GEORGIA MEDICAL LICENSE
GA
Enumeration date
01/28/2006
Last updated
06/30/2021
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