Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | 19006 | NE |
NPI | 1063452845 |
---|---|
Provider Name | Dr. Adeleke E Badejo |
First Address | Kearney, NE 68847-2949 |
Second Address | Kearney, NE 68847-2949 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2006 |
Last Update Date | 24/04/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100143550B | (05) | KS |
100143550C | (05) | KS |
102023 | BLUE CROSS & BLUE SHIELD (01) | KS |
140007700 | RAILROAD MEDICARE (01) | NE |
35675 | BLUE CROSS & BLUE SHIELD (01) | NE |
47084506100 | (05) | NE |
F53479 | (02) | NE |