Individual
DR. SAMUEL GBOYEGA ADEDIRAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.,
Contact information
Practice address
101 E WOOD ST, SPARTANBURG, SC 29303-3040
(864) 560-7050
(864) 560-0800
Mailing address
PO BOX 743070, ATLANTA, GA 30374-3070
(864) 560-4304
(864) 560-4413
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
0101264136
VA
207RH0003X
Hematology & Oncology Physician
Primary
86536
SC
207RH0003X
Hematology & Oncology Physician
MT201305
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
865362
—
SC
01
—
SCL0183365
MEDICARE PIN
SC
01
—
SCL0184746
MEDICARE PIN
SC
Enumeration date
06/13/2012
Last updated
09/29/2021
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