Provider Demographics
NPI:1982668265
Name:OGUNMEFUN, ADELEKE A (MD)
Entity Type:Individual
Prefix:DR
First Name:ADELEKE
Middle Name:A
Last Name:OGUNMEFUN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:134 HOLIDAY CT
Mailing Address - Street 2:SUITE 302
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-7008
Mailing Address - Country:US
Mailing Address - Phone:410-266-1600
Mailing Address - Fax:410-266-5554
Practice Address - Street 1:134 HOLIDAY CT
Practice Address - Street 2:SUITE 302
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-7008
Practice Address - Country:US
Practice Address - Phone:410-266-1600
Practice Address - Fax:410-266-5554
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-14
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD00564322084P0805X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD805801600Medicaid
834M455FMedicare ID - Type Unspecified
H28812Medicare UPIN