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Individual

ADEBOWALE I AJAYI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
6201 GREENBELT RD, SUITE M-18, COLLEGE PARK, MD 20740-2354
(301) 313-9013
(301) 313-9015
Mailing address
6201 GREENBELT RD, SUITE M-18, BERWYN HEIGHTS, MD 20740-2354
(301) 313-9013
(301) 313-9015

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
D045217
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
125931800
MD
01
75859903
BLUE SHIELD
MD
01
P00379380
RAILROAD MED
MD
Enumeration date
05/15/2006
Last updated
10/19/2011
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