Healthcare Provider Details
I. General information
NPI: 1437317005
Provider Name (Legal Business Name): OJEDAPO A. OJEYEMI M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 05/29/2008
Last Update Date: 07/12/2021
Certification Date: 07/12/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5205 CHAIRMANS CT STE 201A
FREDERICK MD
21703-2918
US
IV. Provider business mailing address
5205 CHAIRMANS CT STE 201A
FREDERICK MD
21703-2918
US
V. Phone/Fax
- Phone: 240-629-3939
- Fax: 240-629-3940
- Phone: 240-629-3939
- Fax: 240-629-3940
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207XS0117X |
| Taxonomy | Orthopaedic Surgery of the Spine Physician |
| License Number | MD039826 |
| License Number State | DC |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207XS0117X |
| Taxonomy | Orthopaedic Surgery of the Spine Physician |
| License Number | N5918 |
| License Number State | TX |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207XS0117X |
| Taxonomy | Orthopaedic Surgery of the Spine Physician |
| License Number | D0073234 |
| License Number State | MD |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: