| Ajewole Medical Pllc | |
|
3 Upton Park Rochester NY 14607-1500 | |
| (585) 685-2525 | |
| (585) 385-8502 |
| Full Name | Ajewole Medical Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 3 Upton Park, Rochester, New York |
| Authorized Official Name and Position | Sunkanmi Ajewole (SOLE MEMBER) |
| Authorized Official Contact | 5856877282 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ajewole Medical Pllc 338 Harris Hill Rd Ste 207 Williamsville NY 14221-7470 Ph: (716) 634-4798 | Ajewole Medical Pllc 3 Upton Park Rochester NY 14607-1500 Ph: (585) 685-2525 |
| NPI Number | 1073271540 |
|---|---|
| Provider Enumeration Date | 12/02/2021 |
| Last Update Date | 12/02/2021 |
| Medicare PECOS PAC ID | 6204221815 |
|---|---|
| Medicare Enrollment ID | O20220317002002 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073271540 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Sunkanmi A Ajewole |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1306138664 PECOS PAC ID: 4183841398 Enrollment ID: I20140812002225 |
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