Look up the most recent NPI and PECOS records

Adeyemi Olumayowa Gbogboade

Family Medicine

Allopathic & Osteopathic Physicians

743 Spring St NE Rear 710, Gainesville, GA 30501-3899

PECOS Enrollment

This provider is enrolled in PECOS as ADEYEMI GBOGBOADE.

Based on the most recent information from CMS, provider Adeyemi Olumayowa Gbogboade is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 5 days ago.

Profile Details

Provider ID
1275110496
Provider Type
Individual
Full Name
Gbogboade, Adeyemi Olumayowa
Title
Dr.
Credential
MD

Gender
Male
Sole Proprietor
No
Enumeration Date
3/24/2021
Last Updated
12/11/2024

Contact Information

Practice Location

743 Spring St NE Rear 710, Gainesville, GA 30501-3899

(770) 219-8730

Unlisted Fax

Mailing Location

743 Spring St NE Rear 710, Gainesville, GA 30501-3899

(770) 219-8730

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 207Q00000X Primary	Description Family Medicine Allopathic & Osteopathic Physicians	License 98241 Georgia
Code 390200000X	Description Student in an Organized Health Care Education/Training Program Student, Health Care	License Unlisted Issuer

Adeyemi Olumayowa Gbogboade

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

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