Oluwaseun Ajao, RN

Individual provider Active NPI Registered Nurse · Randallstown, MD

NPI 1649967787 · NPPES record last updated Apr 19, 2023

Key facts

NPI
1649967787
Entity type
Individual (NPI type 1)
Primary specialty
Registered Nurse 163W00000X
License
R256052 (MD)
Practice address
3731 Peace Chance Dr
Randallstown, MD 21133-2853
Phone
(443) 870-1243
NPI assigned
Apr 19, 2023
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
R256052MDMDRegistered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X R256052 MD Yes

Addresses

Primary practice location

3731 Peace Chance Dr
Randallstown, MD 21133-2853

Mailing address

3731 Peace Chance Dr
Randallstown, MD 21133-2853
Phone (443) 870-1243

Other providers in Randallstown, MD

All providers in Randallstown, MD · Registered Nurse in Maryland

Sources for this page

Verify at the official NPI Registry.