Healthcare Provider Details

I. General information

NPI: 1740102581
Provider Name (Legal Business Name): ADETUNJI SARUMI
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/25/2026
Last Update Date: 07/25/2026
Certification Date: 07/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2118 OWLS NEST WAY
JESSUP MD
20794-3268
US

IV. Provider business mailing address

2118 OWLS NEST WAY
JESSUP MD
20794-3268
US

V. Phone/Fax

Practice location:
  • Phone: 443-846-1112
  • Fax:
Mailing address:
  • Phone: 443-846-1112
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License NumberRSA-03344
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: