Adebola A Adejuwon, NP
Individual provider Active NPI Family Nurse Practitioner · Frederick, MD
NPI 1174089239 · NPPES record last updated May 21, 2026
Key facts
- NPI
- 1174089239
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- R220058 (MD)
- Practice address
- 178 Thomas Johnson Dr
Frederick, MD 21702-4386 - Phone
- (301) 673-1901
- NPI assigned
- Feb 13, 2019
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 5
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in MD, DC
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190822002570 | MD | Practitioner - Nurse Practitioner | 3779811146 | Reassigns benefits to 2 organizations |
| I20210819001415 | DC | Practitioner - Nurse Practitioner | 3779811146 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN1033944 | DC | MD | Family Nurse Practitioner |
| R220058 | MD | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Matclinic Physicians Practice Group LLC | Current |
Accepting new patients | |
| Center for Pain Management, LLC | Current |
Accepting new patients | |
| Matclinic Physicians Practice Group LLC | Current |
Accepting new patients | |
| Matclinic Physicians Practice Group LLC | Current |
Accepting new patients | |
| Vertex Health LLC | Past | Accepting new patients |
Locations
940 Seton Dr
Cumberland, MD 21502
Phone (301) 777-2543
40 S Dundalk Ave
Ste 400
Dundalk, MD 21222
Phone (410) 220-0270
1600 Crain Hwy S
Ste 301
Glen Burnie, MD 21061
Phone (410) 760-1400
1150 Professional Ct
Ste P
Hagerstown, MD 21740
Phone (301) 665-9696
11350 McCormick Rd
Ste 501
Hunt Valley, MD 21031
Phone (410) 329-1071
601 7th St
Ste 304
Laurel, MD 20707
Phone (410) 220-0280
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | R220058 | MD | Yes |
| Family Nurse Practitioner | 363LF0000X | RN1033944 | DC |
Addresses
Primary practice location
178 Thomas Johnson Dr
Frederick, MD 21702-4386
Mailing address
178 Thomas Johnson Dr Ste 204L
Frederick, MD 21702-4352
Phone (301) 673-1901
Other providers in Frederick, MD
- Adaptable Health Care
- Adaptive Teaching and Learning Autism Services
- Brandon Adawi
- Lawrencia Afua Addo
- Esther Adejumo
- Kristin Kelley-Higgins Adelmeyer
- Adeoye Adeniran
- Martins Adeogun
- Joshua Adetayo
- Odunola Adeyeye
All providers in Frederick, MD · Family Nurse Practitioner in Maryland
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 21, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.