Provider Demographics
NPI:1932498326
Name:ADEKOYA, OLUWATOSIN ADETOLA
Entity Type:Individual
Prefix:MR
First Name:OLUWATOSIN
Middle Name:ADETOLA
Last Name:ADEKOYA
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 1:1521 HARFORD AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21202-5705
Mailing Address - Country:US
Mailing Address - Phone:410-962-5541
Mailing Address - Fax:410-962-7108
Practice Address - Street 1:1521 HARFORD AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21202-5705
Practice Address - Country:US
Practice Address - Phone:410-962-5541
Practice Address - Fax:410-962-7108
Is Sole Proprietor?:No
Enumeration Date:2011-04-06
Last Update Date:2011-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD14454183500000X, 1835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist