Provider Demographics
NPI:1619715760
Name:AKINSIKU, ADEDAMOLA OLADIPUPO
Entity type:Individual
Prefix:
First Name:ADEDAMOLA
Middle Name:OLADIPUPO
Last Name:AKINSIKU
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:NEPHROLOGY FELLOWSHIP, MEDICAL COLLEGE OF WISCONSIN AFF
Mailing Address - Street 2:9200 W WISCONSIN AVE .
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53226
Mailing Address - Country:US
Mailing Address - Phone:414-955-4578
Mailing Address - Fax:414-955-6409
Practice Address - Street 1:9200 W WISCONSIN AVE MEDICAL COLLEGE OF WISCONSIN
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53226
Practice Address - Country:US
Practice Address - Phone:414-955-4578
Practice Address - Fax:414-955-6409
Is Sole Proprietor?:No
Enumeration Date:2024-07-15
Last Update Date:2024-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WINO.84221-20207RN0300X
WI84221-20390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program