Provider Demographics
NPI:1346506987
Name:BELLO, ADEOLA O
Entity Type:Individual
Prefix:
First Name:ADEOLA
Middle Name:O
Last Name:BELLO
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 1:5804 ANNAPOLIS RD
Mailing Address - Street 2:APT 1012
Mailing Address - City:BLADENSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20710-2076
Mailing Address - Country:US
Mailing Address - Phone:240-441-9310
Mailing Address - Fax:
Practice Address - Street 1:5804 ANNAPOLIS RD
Practice Address - Street 2:APT 1012
Practice Address - City:BLADENSBURG
Practice Address - State:MD
Practice Address - Zip Code:20710-2076
Practice Address - Country:US
Practice Address - Phone:240-441-9310
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-09
Last Update Date:2012-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDB400031660837374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide