Provider Demographics
NPI:1255692661
Name:ADEYEMI, OLUYEMISI ABOSEDE
Entity Type:Individual
Prefix:
First Name:OLUYEMISI
Middle Name:ABOSEDE
Last Name:ADEYEMI
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 1:4317 57TH AVE APT 3
Mailing Address - Street 2:
Mailing Address - City:BLADENSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20710-1714
Mailing Address - Country:US
Mailing Address - Phone:240-278-1358
Mailing Address - Fax:
Practice Address - Street 1:11431 LOCKWOOD DR APT 202
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20904-2611
Practice Address - Country:US
Practice Address - Phone:240-279-1358
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-01
Last Update Date:2020-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide