Provider Demographics
NPI:1265987812
Name:AJUWON, FOLUKE OLUFUNBI
Entity type:Individual
Prefix:
First Name:FOLUKE
Middle Name:OLUFUNBI
Last Name:AJUWON
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 1:15320 OLD FREDERICK RD
Mailing Address - Street 2:
Mailing Address - City:WOODBINE
Mailing Address - State:MD
Mailing Address - Zip Code:21797-8748
Mailing Address - Country:US
Mailing Address - Phone:240-938-4333
Mailing Address - Fax:
Practice Address - Street 1:HOWARD COUNTY HEALTH DEPARTMENT
Practice Address - Street 2:8930 STANFORD BLVD
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21045-5805
Practice Address - Country:US
Practice Address - Phone:410-313-7500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-23
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDRN175562363LF0000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health