Provider Demographics
NPI:1558648915
Name:ODEWALE, ADEOLU TOPE (PHARMD, RPH)
Entity type:Individual
Prefix:DR
First Name:ADEOLU
Middle Name:TOPE
Last Name:ODEWALE
Suffix:
Gender:M
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 MISTY MEADOWS CT
Mailing Address - Street 2:
Mailing Address - City:ESSEX
Mailing Address - State:MD
Mailing Address - Zip Code:21221-3353
Mailing Address - Country:US
Mailing Address - Phone:301-220-3124
Mailing Address - Fax:301-220-1738
Practice Address - Street 1:5510 CHERRYWOOD LN
Practice Address - Street 2:
Practice Address - City:GREENBELT
Practice Address - State:MD
Practice Address - Zip Code:20770-1003
Practice Address - Country:US
Practice Address - Phone:301-220-3124
Practice Address - Fax:301-220-1738
Is Sole Proprietor?:No
Enumeration Date:2011-11-12
Last Update Date:2014-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH233484183500000X
NH3743183500000X
MD20589183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist