Provider Demographics
NPI:1134278849
Name:ADEGBOLA, ONIKEPE (MD PHD)
Entity type:Individual
Prefix:DR
First Name:ONIKEPE
Middle Name:
Last Name:ADEGBOLA
Suffix:
Gender:F
Credentials:MD PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:170 N HENDERSON RD STE 310
Mailing Address - Street 2:
Mailing Address - City:KING OF PRUSSIA
Mailing Address - State:PA
Mailing Address - Zip Code:19406-2155
Mailing Address - Country:US
Mailing Address - Phone:610-486-5870
Mailing Address - Fax:610-298-9147
Practice Address - Street 1:170 N HENDERSON RD STE 310
Practice Address - Street 2:
Practice Address - City:KING OF PRUSSIA
Practice Address - State:PA
Practice Address - Zip Code:19406-2155
Practice Address - Country:US
Practice Address - Phone:610-486-5870
Practice Address - Fax:610-298-9147
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-10
Last Update Date:2025-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT45473208D00000X
PAMD438058208D00000X
PAMT186720207U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No207U00000XAllopathic & Osteopathic PhysiciansNuclear Medicine