Adefeyisan, Samuel Adekunle
Adefeyisan, Samuel Adekunle is an individual health care provider with primary practice located at 4314 Clayton St , Grand Prairie TX 75052-3433. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Anesthesiology, Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Pediatric Critical Care Medicine. Allopathic & Osteopathic Physicians / Anesthesiology is his primary health care specialty. Adefeyisan, Samuel Adekunle can be contacted via phone (214) 708-9590.Contact Information
Primary practice address
4314 Clayton St
Grand Prairie TX 75052-3433
Phone: (214) 708-9590
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Anesthesiology | 207L00000X | MD.29707 | Alabama |
| Allopathic & Osteopathic Physicians / Anesthesiology | 207L00000X | 83699 | South Carolina |
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 062934 | Georgia |
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | MD.2009 | Alabama |
| Allopathic & Osteopathic Physicians / Pediatric Critical Care Medicine | 2080P0203X | 062934 | Georgia |
| Allopathic & Osteopathic Physicians / Pediatric Critical Care Medicine | 2080P0203X | MD.29707 | Alabama |
| Allopathic & Osteopathic Physicians / Anesthesiology | 207L00000X | 062934 | Georgia |
Profile Details
| NPI number | 1568673556 |
|---|---|
| LBN Legal business name | Adefeyisan, Samuel Adekunle |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 24th, 2007 |
| Last updated | Dec 16th, 2024 - about 2 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1568673556 | NPPES |
| South Carolina | MEDICAID | Q46839 |
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