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Individual

MRS. ANTHONIA D ADEWOLE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D

Contact information

Practice address
2120 PRAIRIE DR STE 502, PROSPER, TX 75078-3820
(469) 447-4893
(469) 447-4925
Mailing address
2120 PRAIRIE DR STE 502, PROSPER, TX 75078-3820
(469) 447-4893
(469) 447-4925

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
SSN/ITIN DELETED
CT
208C00000X
Colon & Rectal Surgery Physician
073405
GA
208C00000X
Colon & Rectal Surgery Physician
Primary
T9330
TX

Other

Enumeration date
03/31/2009
Last updated
07/11/2025
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