Provider Demographics
NPI:1255890752
Name:OYEWO, ADESOLA (RPH)
Entity type:Individual
Prefix:MS
First Name:ADESOLA
Middle Name:
Last Name:OYEWO
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:414 LIGHT ST UNIT 1506
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21202-1275
Mailing Address - Country:US
Mailing Address - Phone:404-247-6332
Mailing Address - Fax:
Practice Address - Street 1:3300 BELAIR RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21213-1203
Practice Address - Country:US
Practice Address - Phone:410-522-3843
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-14
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD18982183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD18982OtherMARYLAND BOARD OF PHARMACY
GARPH025175OtherGEORGIA BOARD OF PHARMACY