Provider Demographics
NPI:1013189612
Name:OLUREMI T ILUPEJU MD PA
Entity Type:Organization
Organization Name:OLUREMI T ILUPEJU MD PA
Other - Org Name:SETIF, INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:OLUREMI
Authorized Official - Middle Name:TUNDE
Authorized Official - Last Name:ILUPEJU
Authorized Official - Suffix:
Authorized Official - Credentials:MS, MD
Authorized Official - Phone:301-674-9319
Mailing Address - Street 1:7221 HANOVER PKWY STE C
Mailing Address - Street 2:
Mailing Address - City:GREENBELT
Mailing Address - State:MD
Mailing Address - Zip Code:20770-2022
Mailing Address - Country:US
Mailing Address - Phone:301-439-4422
Mailing Address - Fax:301-439-0968
Practice Address - Street 1:7221 HANOVER PKWY STE C
Practice Address - Street 2:
Practice Address - City:GREENBELT
Practice Address - State:MD
Practice Address - Zip Code:20770-2022
Practice Address - Country:US
Practice Address - Phone:301-439-4422
Practice Address - Fax:301-439-0968
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-24
Last Update Date:2021-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0033392174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
420988Medicare PIN
E63727Medicare UPIN