Provider Demographics
NPI:1083711733
Name:OGUNRINDE, ADETEJU (MD)
Entity Type:Individual
Prefix:DR
First Name:ADETEJU
Middle Name:
Last Name:OGUNRINDE
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 1:605 POST OFFICE RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:WALDORF
Mailing Address - State:MD
Mailing Address - Zip Code:20602-1913
Mailing Address - Country:US
Mailing Address - Phone:301-870-1789
Mailing Address - Fax:301-374-2662
Practice Address - Street 1:605 POST OFFICE RD
Practice Address - Street 2:SUITE 102
Practice Address - City:WALDORF
Practice Address - State:MD
Practice Address - Zip Code:20602-1913
Practice Address - Country:US
Practice Address - Phone:301-870-1789
Practice Address - Fax:301-374-2662
Is Sole Proprietor?:No
Enumeration Date:2006-09-17
Last Update Date:2012-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD47254208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD224416100Medicaid
MD1548544992OtherNATIONAL NPI -PRACTICE
MD359185900Medicaid
MD224416100Medicaid