Provider Demographics
NPI:1922490218
Name:OLOJOLA, EKERE EKANDEM (RD, LD)
Entity Type:Individual
Prefix:MRS
First Name:EKERE
Middle Name:EKANDEM
Last Name:OLOJOLA
Suffix:
Gender:F
Credentials:RD, LD
Other - Prefix:MS
Other - First Name:EKERE
Other - Middle Name:
Other - Last Name:EKANDEM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD, LD
Mailing Address - Street 1:15609 MILLBROOK LN
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20707-3317
Mailing Address - Country:US
Mailing Address - Phone:202-309-0260
Mailing Address - Fax:
Practice Address - Street 1:15609 MILLBROOK LN
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20707-3317
Practice Address - Country:US
Practice Address - Phone:202-309-0260
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-24
Last Update Date:2015-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCDI100000470133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered