Provider Demographics
NPI:1336376623
Name:BADA, OLUWAFUNMILOLA TEMITOPE (MD)
Entity Type:Individual
Prefix:DR
First Name:OLUWAFUNMILOLA
Middle Name:TEMITOPE
Last Name:BADA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:TEMITOPE
Other - Middle Name:
Other - Last Name:BADA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:1111 SPRING ST
Mailing Address - Street 2:SUITE 220
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-4003
Mailing Address - Country:US
Mailing Address - Phone:301-585-0040
Mailing Address - Fax:301-565-8079
Practice Address - Street 1:1111 SPRING ST
Practice Address - Street 2:SUITE 220
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-4003
Practice Address - Country:US
Practice Address - Phone:301-585-0040
Practice Address - Fax:301-565-8079
Is Sole Proprietor?:No
Enumeration Date:2009-06-15
Last Update Date:2019-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0069373207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
G400-0006OtherCAREFIRST BCBS FEDERAL
MD022887700Medicaid
MD965073-01OtherCAREFIRST BCBS MARYLAND