Healthcare Provider Details

I. General information

NPI: 1821958729
Provider Name (Legal Business Name): GLORY PEDIATRICS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/13/2025
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4696 MILLENNIUM DR STE 110
BELCAMP MD
21017-1556
US

IV. Provider business mailing address

196 CHIMNEY OAK DR
JOPPA MD
21085-4768
US

V. Phone/Fax

Practice location:
  • Phone: 410-299-4912
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: OYEBUKOLA AJIKE OYEDIRAN
Title or Position: PHYSICIAN/OWNER
Credential: MD
Phone: 443-743-9572