Provider Demographics
NPI:1679283782
Name:WINDAPO, ADEYINKA
Entity Type:Individual
Prefix:
First Name:ADEYINKA
Middle Name:
Last Name:WINDAPO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6400 BALTIMORE NATIONAL PIKE STE 250B
Mailing Address - Street 2:
Mailing Address - City:CATONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21228-3947
Mailing Address - Country:US
Mailing Address - Phone:410-227-7595
Mailing Address - Fax:
Practice Address - Street 1:6400 BALTIMORE NATIONAL PIKE STE 250B
Practice Address - Street 2:
Practice Address - City:CATONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21228-3947
Practice Address - Country:US
Practice Address - Phone:410-227-7595
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-29
Last Update Date:2022-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor
No172A00000XOther Service ProvidersDriver