Temidayo Adedeji-Fajobi
Individual provider Active NPI Military Health Care Provider · Portsmouth, VA
NPI 1972307783 · NPPES record last updated Apr 2, 2025
Key facts
- NPI
- 1972307783
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Military Health Care Provider 171000000X
- Practice address
- 620 John Paul Jones Cir
Portsmouth, VA 23708-2111 - Phone
- (757) 953-7716
- NPI assigned
- Apr 2, 2025
- Sex
- Female
- 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
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Military Health Care Provider | 171000000X | Yes |
Addresses
Primary practice location
620 John Paul Jones Cir
Portsmouth, VA 23708-2111
Mailing address
620 John Paul Jones Cir
Portsmouth, VA 23708-2111
Phone (757) 953-7716
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- Latasha Adgerson
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All providers in Portsmouth, VA · Military Health Care Provider in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 2, 2025. 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.