Provider Demographics
NPI:1083134829
Name:ADEKUNBI, ADESHEWA (MD)
Entity Type:Individual
Prefix:MRS
First Name:ADESHEWA
Middle Name:
Last Name:ADEKUNBI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3704 BIRKDALE CT
Mailing Address - Street 2:
Mailing Address - City:DAVIDSONVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21035-1172
Mailing Address - Country:US
Mailing Address - Phone:301-646-1520
Mailing Address - Fax:
Practice Address - Street 1:3704 BIRKDALE CT
Practice Address - Street 2:
Practice Address - City:DAVIDSONVILLE
Practice Address - State:MD
Practice Address - Zip Code:21035-1172
Practice Address - Country:US
Practice Address - Phone:301-646-1520
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-22
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD10831348292084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD1083134829OtherNON-MEDICARE