Provider Demographics
NPI:1265630750
Name:JAJI, ABAYOMI ISHMAEL (MD)
Entity Type:Individual
Prefix:
First Name:ABAYOMI
Middle Name:ISHMAEL
Last Name:JAJI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3808 COTTON TREE LN
Mailing Address - Street 2:
Mailing Address - City:BURTONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20866-3110
Mailing Address - Country:US
Mailing Address - Phone:240-472-4382
Mailing Address - Fax:301-421-5980
Practice Address - Street 1:2700 MARTIN LUTHER KING JR AVE SE
Practice Address - Street 2:JHP
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20032
Practice Address - Country:US
Practice Address - Phone:202-645-4900
Practice Address - Fax:202-645-8733
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCDCMD322362084F0202X, 2084P0800X, 2084P0805X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered2084F0202XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyForensic Psychiatry
Not Answered2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Not Answered2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC4429030Medicare ID - Type Unspecified
490660Medicare ID - Type Unspecified