Provider Demographics
NPI:1568407898
Name:ADENUGA, BABAFEMI B (MD)
Entity Type:Individual
Prefix:
First Name:BABAFEMI
Middle Name:B
Last Name:ADENUGA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2024 GEORGIA AVE NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20001-3027
Mailing Address - Country:US
Mailing Address - Phone:202-865-3415
Mailing Address - Fax:202-865-6876
Practice Address - Street 1:2139 GEORGIA AVE NW
Practice Address - Street 2:4TH FLOOR
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20001-3035
Practice Address - Country:US
Practice Address - Phone:202-865-7499
Practice Address - Fax:202-865-3875
Is Sole Proprietor?:No
Enumeration Date:2006-06-19
Last Update Date:2007-08-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
DCMD31206207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
00B596H13Medicare PIN
H10444Medicare UPIN