Provider Demographics
NPI:1164956876
Name:MAJEKODUNMI, MOJISOLA
Entity Type:Individual
Prefix:
First Name:MOJISOLA
Middle Name:
Last Name:MAJEKODUNMI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8912 CONGRESS PL
Mailing Address - Street 2:
Mailing Address - City:LANDOVER
Mailing Address - State:MD
Mailing Address - Zip Code:20785-4726
Mailing Address - Country:US
Mailing Address - Phone:240-705-5555
Mailing Address - Fax:
Practice Address - Street 1:8912 CONGRESS PL
Practice Address - Street 2:
Practice Address - City:LANDOVER
Practice Address - State:MD
Practice Address - Zip Code:20785-4726
Practice Address - Country:US
Practice Address - Phone:240-705-5555
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-19
Last Update Date:2017-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide