Healthcare Provider Details

I. General information

NPI: 1316365174
Provider Name (Legal Business Name): PEJU OLAJIDE ADEKOYA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: ADEPEJU OLAJIDE ADEKOYA M.D.

II. Dates (important events)

Enumeration Date: 03/30/2014
Last Update Date: 04/12/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 ORLEANS ST
BALTIMORE MD
21287
US

IV. Provider business mailing address

9910 FRANKLIN SQUARE DR # 2110
BALTIMORE MD
21236-4902
US

V. Phone/Fax

Practice location:
  • Phone: 410-955-5000
  • Fax:
Mailing address:
  • Phone: 410-933-6421
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberD87030
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License NumberD87030
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: