Adeniyi, John A

Adeniyi, John A is an individual health care provider with primary practice located at 527 Medical Park Dr Ste 501 , Bridgeport WV 26330. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology, Allopathic & Osteopathic Physicians / Vascular Surgery. Allopathic & Osteopathic Physicians / Vascular Surgery is his primary health care specialty. Adeniyi, John A can be contacted via phone (304) 842-3993.

Contact Information

Primary practice address
527 Medical Park Dr Ste 501 Bridgeport WV 26330
Phone: (304) 842-3993
Fax: (304) 842-4083
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology 2085R0204X WV21293 West Virginia
Allopathic & Osteopathic Physicians / Vascular Surgery 2086S0129X WV21293 West Virginia

Profile Details

NPI number 1306920756
LBN Legal business name Adeniyi, John A
Credentials M.D., F.A.C.S.
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 24th, 2006
Last updated Apr 6th, 2022 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1306920756 NPPES
West Virginia Other P00093109 RR MC
West Virginia Other 001719007 RR MC
West Virginia MEDICAID 3810000654 RR MC

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