Provider Demographics
NPI:1437850039
Name:ADARALEGBE, ADESHOLA OLAMIDE (MD)
Entity Type:Individual
Prefix:
First Name:ADESHOLA
Middle Name:OLAMIDE
Last Name:ADARALEGBE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2906 BUCKTHORN CT
Mailing Address - Street 2:
Mailing Address - City:GLENARDEN
Mailing Address - State:MD
Mailing Address - Zip Code:20706-5518
Mailing Address - Country:US
Mailing Address - Phone:267-584-2246
Mailing Address - Fax:
Practice Address - Street 1:2906 BUCKTHORN CT
Practice Address - Street 2:
Practice Address - City:GLENARDEN
Practice Address - State:MD
Practice Address - Zip Code:20706-5518
Practice Address - Country:US
Practice Address - Phone:267-584-2246
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-13
Last Update Date:2023-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty