Ayorinde C Adenegan

Individual provider Active NPI Home Health Agency · Baltimore, MD

NPI 1700459385 · NPPES record last updated Jul 21, 2021

Key facts

NPI
1700459385
Entity type
Individual (NPI type 1)
Primary specialty
Home Health Agency 251E00000X
License
R5083P (MD)
Practice address
1310 Bedford Ave
Baltimore, MD 21208-3798
Phone
(410) 484-0062
Fax
(410) 653-0626
NPI assigned
Jul 21, 2021
Sex
Male
Sole proprietor
Yes

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
R5083PMDMDHome Health Agency

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X R5083P MD Yes

Addresses

Primary practice location

1310 Bedford Ave
Baltimore, MD 21208-3798

Mailing address

1310 Bedford Ave
Baltimore, MD 21208-3798
Phone (410) 484-0062

Other providers in Baltimore, MD

All providers in Baltimore, MD · Home Health Agency in Maryland

Sources for this page

Verify at the official NPI Registry.