Individual
DR. BOLAJOKO O FAYODA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3821 MASTHEAD ST NE, ALBUQUERQUE, NM 87109-4679
(505) 998-7400
Mailing address
6700 MODESTO AVE NE APT 1028, ALBUQUERQUE, NM 87113-3209
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
83325
WI
207RN0300X
Nephrology Physician
Primary
MD2025-0657
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7S1114
MEDICARE
—
05
—
N0026546
—
NM
Enumeration date
06/29/2015
Last updated
04/10/2026
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