Oluwadamilola Nurude Adisa
Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Baltimore, MD
NPI 1508538356 · NPPES record last updated May 21, 2024
Key facts
- NPI
- 1508538356
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Student in an Organized Health Care Education/Training Program 390200000X
- Practice address
- 1800 Orleans Street
Baltimore, MD 21264-4228 - Phone
- (410) 955-5000
- NPI assigned
- Sep 30, 2021
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MD
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240529001168 | MD | Order and Referring Only - Internal Medicine |
4082056601 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Interoperability endpoints
- oadisa1239076@direct.hopkinsmedicine.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Yes |
Addresses
Primary practice location
1800 Orleans Street
Baltimore, MD 21264-4228
Mailing address
6201 Greenleigh Ave
Middle River, MD 21220-2004
Phone (410) 933-6423
Other practice location 1
1501 Kings Hwy
Shreveport, LA 71103-4228
Phone (318) 626-0434
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- Oluwatoyin Clara Adisa
- Dora Adjei
- Stephanie Adjei
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All providers in Baltimore, MD · Student in an Organized Health Care Education/Training Program 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, 2024. 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.