Provider Demographics
NPI:1174344626
Name:ADEWOLE, BABATUNDE KAZEEM
Entity type:Individual
Prefix:MR
First Name:BABATUNDE
Middle Name:KAZEEM
Last Name:ADEWOLE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:539 LAKE ST
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:OH
Mailing Address - Zip Code:44240-2644
Mailing Address - Country:US
Mailing Address - Phone:234-327-1921
Mailing Address - Fax:
Practice Address - Street 1:539 LAKE ST
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:OH
Practice Address - Zip Code:44240-2644
Practice Address - Country:US
Practice Address - Phone:234-327-1921
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-17
Last Update Date:2024-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care