Provider Demographics
NPI:1174150908
Name:ADEBEKUN, OLUWASEYI TOLUWANI (MD)
Entity type:Individual
Prefix:
First Name:OLUWASEYI
Middle Name:TOLUWANI
Last Name:ADEBEKUN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:213 RIVER WALK PKWY STE 101
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23320-6893
Mailing Address - Country:US
Mailing Address - Phone:757-983-1777
Mailing Address - Fax:
Practice Address - Street 1:213 RIVER WALK PKWY STE 101
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-6893
Practice Address - Country:US
Practice Address - Phone:757-983-1777
Practice Address - Fax:757-507-9043
Is Sole Proprietor?:No
Enumeration Date:2020-03-23
Last Update Date:2023-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
VA0101279108207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program