Temitayo Banjo
Individual provider Active NPI Pharmacist · Baltimore, MD
NPI 1275909442 · NPPES record last updated Sep 23, 2020
Key facts
- NPI
- 1275909442
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 24057 (MD)
- Practice address
- 19 E Fayette St
Baltimore, MD 21202-6420 - Phone
- (410) 625-1817
- NPI assigned
- Aug 11, 2015
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 24057 | MD | MD | Social Worker |
| E-13965 | MS | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | E-13965 | MS | |
| Pharmacist | 183500000X | 24057 | MD | Yes |
Addresses
Primary practice location
19 E Fayette St
Baltimore, MD 21202-6420
Mailing address
19 E Fayette St
Baltimore, MD 21202-6420
Phone (410) 625-1817
Other practice location 1
1497 Canton Mart Rd
Jackson, MS 39211-5435
Phone (601) 956-2421
Other providers in Baltimore, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 23, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.