Provider Demographics
NPI:1740535673
Name:ADEYIGA, ADESOLA
Entity type:Individual
Prefix:
First Name:ADESOLA
Middle Name:
Last Name:ADEYIGA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2310 BRIGHTSEAT RD
Mailing Address - Street 2:1
Mailing Address - City:LANDOVER
Mailing Address - State:MD
Mailing Address - Zip Code:20785-3552
Mailing Address - Country:US
Mailing Address - Phone:202-545-0935
Mailing Address - Fax:202-545-0934
Practice Address - Street 1:2310 BRIGHTSEAT RD
Practice Address - Street 2:1
Practice Address - City:LANDOVER
Practice Address - State:MD
Practice Address - Zip Code:20785-3552
Practice Address - Country:US
Practice Address - Phone:202-545-0935
Practice Address - Fax:202-545-0934
Is Sole Proprietor?:No
Enumeration Date:2012-07-17
Last Update Date:2012-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide