Provider Demographics
NPI:1558518589
Name:JINADU, NUSIRAT ADEPEJU ADEBIMPE (MD)
Entity Type:Individual
Prefix:
First Name:NUSIRAT
Middle Name:ADEPEJU ADEBIMPE
Last Name:JINADU
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 1:224-D CORNWALL STREET, NW, SUITE 403
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:VA
Mailing Address - Zip Code:20176-2700
Mailing Address - Country:US
Mailing Address - Phone:703-737-6010
Mailing Address - Fax:703-443-8643
Practice Address - Street 1:19490 SANDRIDGE WAY, SUITE 120
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:VA
Practice Address - Zip Code:20176-3469
Practice Address - Country:US
Practice Address - Phone:703-723-5555
Practice Address - Fax:703-562-6996
Is Sole Proprietor?:No
Enumeration Date:2008-08-21
Last Update Date:2023-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD78226207R00000X, 207RN0300X
VA0101269359207RN0300X
MI4301092117207R00000X
WI71913208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1558518589Medicaid
VA30016449500002Medicaid