Provider Demographics
NPI:1134429236
Name:ORIAIFO, ADETORO ADEYINKA
Entity type:Individual
Prefix:MRS
First Name:ADETORO
Middle Name:ADEYINKA
Last Name:ORIAIFO
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 1:4542 VERMEER CT
Mailing Address - Street 2:
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-7900
Mailing Address - Country:US
Mailing Address - Phone:410-740-7406
Mailing Address - Fax:
Practice Address - Street 1:5485 HARPERS FARM RD STE A
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21044-1107
Practice Address - Country:US
Practice Address - Phone:410-740-3332
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-25
Last Update Date:2010-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDP02231183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist