Individual
MODUPE O ADEFIYIJU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7055 SAMUEL MORSE DR, COLUMBIA, MD 21046-3439
(443) 739-6121
(301) 725-0163
Mailing address
14205 DOWNDALE CT, LAUREL, MD 20707-6883
(443) 739-6121
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R183736
MD
Other
Enumeration date
11/24/2020
Last updated
01/12/2021
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