Provider Demographics
NPI:1801283544
Name:BABALOLA, OLADAPO (MR)
Entity type:Individual
Prefix:
First Name:OLADAPO
Middle Name:
Last Name:BABALOLA
Suffix:
Gender:M
Credentials:MR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1120 SAINT PAUL ST
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21202-2618
Mailing Address - Country:US
Mailing Address - Phone:410-446-4119
Mailing Address - Fax:410-685-3252
Practice Address - Street 1:1120 SAINT PAUL ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21202-2618
Practice Address - Country:US
Practice Address - Phone:410-446-4119
Practice Address - Fax:410-685-3252
Is Sole Proprietor?:No
Enumeration Date:2015-04-21
Last Update Date:2015-04-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDA3459225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant