Individual
DR. BAMIDELE ANUOLUWA AJAYI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
13425 HOOVER CREEK BLVD STE 101, CHARLOTTE, NC 28273
(704) 384-1246
(704) 384-6072
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(704) 384-1246
(704) 384-6072
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
2016-00983
NC
2084P0800X
Psychiatry Physician
259100
NY
2084P0804X
Child & Adolescent Psychiatry Physician
2016-00983
NC
2084P0804X
Child & Adolescent Psychiatry Physician
259100
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1417995978
—
NC
05
—
NC2975
—
SC
Enumeration date
06/04/2006
Last updated
10/26/2020
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