Provider Demographics
NPI:1457040297
Name:ALABI, ADEYEMI SAMUEL
Entity Type:Individual
Prefix:MR
First Name:ADEYEMI
Middle Name:SAMUEL
Last Name:ALABI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7532 STONEHOUSE RUN DR
Mailing Address - Street 2:
Mailing Address - City:GLEN BURNIE
Mailing Address - State:MD
Mailing Address - Zip Code:21060-8468
Mailing Address - Country:US
Mailing Address - Phone:443-760-8979
Mailing Address - Fax:
Practice Address - Street 1:5525 SEWARD AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21206-4425
Practice Address - Country:US
Practice Address - Phone:443-760-8979
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-08
Last Update Date:2023-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide