Provider Demographics
NPI:1558516187
Name:OSHODI, PATRICIA ADAOBI OLADUNNI (MD)
Entity Type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:ADAOBI OLADUNNI
Last Name:OSHODI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:PATRICIA
Other - Middle Name:ADAOBI OLADUNNI
Other - Last Name:ENEKWE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:6104 OLD BRANCH AVE
Mailing Address - Street 2:
Mailing Address - City:TEMPLE HILLS
Mailing Address - State:MD
Mailing Address - Zip Code:20748-2518
Mailing Address - Country:US
Mailing Address - Phone:301-702-6100
Mailing Address - Fax:
Practice Address - Street 1:6104 OLD BRANCH AVE
Practice Address - Street 2:
Practice Address - City:TEMPLE HILLS
Practice Address - State:MD
Practice Address - Zip Code:20748-2518
Practice Address - Country:US
Practice Address - Phone:301-702-6100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-24
Last Update Date:2021-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD038248207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA217906YWAUMedicare PIN
MD236458ZDDBMedicare PIN
VAVAA100493Medicare PIN
MD236458YVZMedicare PIN