Provider Demographics
NPI:1801250816
Name:ADENIJI, ADEDOYIN C
Entity type:Individual
Prefix:
First Name:ADEDOYIN
Middle Name:C
Last Name:ADENIJI
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 1:1900 MASSACHUSETTS AVE SE
Mailing Address - Street 2:BLDG 15
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20003-2542
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1900 MASSACHUSETTS AVE SE
Practice Address - Street 2:BLDG 15
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20003-2542
Practice Address - Country:US
Practice Address - Phone:202-698-4040
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-06
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR185028261QP2300X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care