Provider Demographics
NPI:1114265527
Name:BABATUNDE, AFEEZ O
Entity Type:Individual
Prefix:MR
First Name:AFEEZ
Middle Name:O
Last Name:BABATUNDE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1259 STOCKPORT CT
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20721-1837
Mailing Address - Country:US
Mailing Address - Phone:240-535-7747
Mailing Address - Fax:
Practice Address - Street 1:1259 STOCKPORT CT
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20721-1837
Practice Address - Country:US
Practice Address - Phone:240-535-7747
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-18
Last Update Date:2013-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCRN62612163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health