Provider Demographics
NPI:1164100780
Name:ASHADE, ADEOLA TAJUDEEN
Entity Type:Individual
Prefix:MR
First Name:ADEOLA
Middle Name:TAJUDEEN
Last Name:ASHADE
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 1:714 PAREV WAY
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20774-1690
Mailing Address - Country:US
Mailing Address - Phone:202-983-3686
Mailing Address - Fax:
Practice Address - Street 1:714 PAREV WAY
Practice Address - Street 2:
Practice Address - City:UPPER MARLBORO
Practice Address - State:MD
Practice Address - Zip Code:20774-1690
Practice Address - Country:US
Practice Address - Phone:202-983-3686
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-05
Last Update Date:2023-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide