Active NPI
Olubode Olufajo
- Surgery Physician
- Randallstown, MD
National Provider Identifier
1942652458
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- D0086028
- Practice address
- 5401 Old Court Rd
Randallstown, MD 21133-5103 - Phone
- (410) 521-2200
- NPI assigned
- Jul 8, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 2016012632 | MO | |
| Surgery Physician | 208600000X | D0086028 | MD | Primary |
Addresses
Primary practice location
5401 Old Court Rd
Randallstown, MD 21133-5103
Mailing address
2041 Georgia Ave
Department of Surgery, Howard University Hospital
Washington, DC 20060-1010
Phone (202) 865-7179
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D0086028 | MD | MD | Surgery Physician |
| 2016012632 | MO | MD | Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1467936000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1559520000000",
"number": "1942652458",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2041 GEORGIA AVE",
"address_2": "DEPARTMENT OF SURGERY, HOWARD UNIVERSITY HOSPITAL",
"city": "WASHINGTON",
"state": "DC",
"postal_code": "200601010",
"telephone_number": "202-865-7179"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5401 OLD COURT RD",
"city": "RANDALLSTOWN",
"state": "MD",
"postal_code": "211335103",
"telephone_number": "410-521-2200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OLUFAJO",
"first_name": "OLUBODE",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-07-08",
"last_updated": "2019-06-03",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "MO",
"license": "2016012632",
"primary": false
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "MD",
"license": "D0086028",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Randallstown, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.