Provider Demographics
NPI:1508901281
Name:OLUGEMO, OLUKEMI AJAYI (MD)
Entity Type:Individual
Prefix:DR
First Name:OLUKEMI
Middle Name:AJAYI
Last Name:OLUGEMO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:OLUKEMI
Other - Middle Name:FEHINTOLA
Other - Last Name:AJAYI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3525 ELLERTON RD
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20716-3926
Mailing Address - Country:US
Mailing Address - Phone:443-928-2835
Mailing Address - Fax:301-805-0161
Practice Address - Street 1:11637 TERRACE DR
Practice Address - Street 2:SUITE 100
Practice Address - City:WALDORF
Practice Address - State:MD
Practice Address - Zip Code:20602-3706
Practice Address - Country:US
Practice Address - Phone:301-870-7287
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-21
Last Update Date:2008-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD00653572084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology