Basic Information
| Provider Information | |||||||||
| NPI: | 1952500423 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ADEGOROYE | ||||||||
| FirstName: | ADEYINKA | ||||||||
| MiddleName: | ABIMBOLA | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MB CHB | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3561 RAMSAY ST | ||||||||
| Address2: | APT 1B | ||||||||
| City: | HIGH POINT | ||||||||
| State: | NC | ||||||||
| PostalCode: | 272659029 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9177707512 | ||||||||
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| Practice Location | |||||||||
| Address1: | 404 WESTWOOD AVE | ||||||||
| Address2: | SUITE 105 | ||||||||
| City: | HIGH POINT | ||||||||
| State: | NC | ||||||||
| PostalCode: | 272624315 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3368826500 | ||||||||
| FaxNumber: | 3368826501 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/16/2007 | ||||||||
| LastUpdateDate: | 07/04/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 174400000X | 003032 | NY | N | Other Service Providers | Specialist | 207RN0300X | 2010-00955 | NC | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Nephrology |
No ID Information.