Provider Demographics
NPI:1497057533
Name:RUFAI, BAMIDELE DURO (RD)
Entity Type:Individual
Prefix:MS
First Name:BAMIDELE
Middle Name:DURO
Last Name:RUFAI
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7010 GOOD LUCK RD
Mailing Address - Street 2:
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-3709
Mailing Address - Country:US
Mailing Address - Phone:240-487-6270
Mailing Address - Fax:202-332-9763
Practice Address - Street 1:7010 GOOD LUCK RD
Practice Address - Street 2:
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-3709
Practice Address - Country:US
Practice Address - Phone:240-487-6270
Practice Address - Fax:202-332-9763
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-22
Last Update Date:2010-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCD1319133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist