DoctorDataHub
Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

MR. ADEKUNLE OLADEGA AJISEBUTU, MD

Deactivated

MR. ADEKUNLE OLADEGA AJISEBUTU, MD is a Sports Medicine (IM) healthcare provider located in DES MOINES, Iowa. NPI 1235518507 is deactivated in the NPPES registry. Verify at CMS.

Sports Medicine (IM) · DES MOINES, IA

This NPI has been deactivated. The record was deactivated on January 13, 2016. Deactivated NPIs are no longer valid for billing or credentialing. The provider may have retired, changed practice status, or had their NPI administratively deactivated. Verify current licensure status with the NPPES NPI Registry or the relevant state medical board before relying on this record.

Registration Details

NPI Number
1235518507
Provider Type
Individual
Gender
Male
NPI Issued
May 20, 2015 (0.65027322404372 yrs)
Last Updated
May 25, 2022
Deactivated
Jan 13, 2016
License
MD-47364 (IA)

Practice Information

Address
1350 DES MOINES ST STE 100
DES MOINES, IA, 503095507
Browse IA providers · Browse ZIP 50309
Phone
5153589600
Fax
5153589650
Primary Specialty
Sports Medicine (IM)
207RS0012X
Additional Specialty
Sports Medicine (IM)

Other Sports Medicine (IM) Providers in DES MOINES, IA

Name Credential NPI
DR. DONALD L BURROWS MD 1508844317
DR. ROGER T LIU MD 1841278595
SARITA KUMARI MD 1336209899
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.