Provider Demographics
NPI:1942864160
Name:OLUWALADE, ADEJUMOKE AFOLASADE
Entity Type:Individual
Prefix:
First Name:ADEJUMOKE
Middle Name:AFOLASADE
Last Name:OLUWALADE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ADEJUMOKE
Other - Middle Name:AFOLASADE
Other - Last Name:AJAYI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8629 STONE HILL LN
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20724-2495
Mailing Address - Country:US
Mailing Address - Phone:202-403-9296
Mailing Address - Fax:
Practice Address - Street 1:8629 STONE HILL LN
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20724-2495
Practice Address - Country:US
Practice Address - Phone:202-403-9296
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-23
Last Update Date:2019-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAHHA2921374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide