Provider Demographics
NPI:1720411036
Name:ADEYEMO, DANIEL
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:
Last Name:ADEYEMO
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 1:8319 LIBERTY RD
Mailing Address - Street 2:
Mailing Address - City:WINDSOR MILL
Mailing Address - State:MD
Mailing Address - Zip Code:21244-3127
Mailing Address - Country:US
Mailing Address - Phone:443-271-4536
Mailing Address - Fax:410-701-7375
Practice Address - Street 1:8319 LIBERTY RD
Practice Address - Street 2:
Practice Address - City:WINDSOR MILL
Practice Address - State:MD
Practice Address - Zip Code:21244-3127
Practice Address - Country:US
Practice Address - Phone:443-271-4536
Practice Address - Fax:410-701-7375
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-10
Last Update Date:2013-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDMT0044255247200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other