Healthcare Provider Details

I. General information

NPI: 1881344059
Provider Name (Legal Business Name): ADEIYEWUNMI BAMIDELE OSINUBI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ADE BAMIDELE OSINUBI MD

II. Dates (important events)

Enumeration Date: 03/28/2022
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 FOREST GLEN RD
SILVER SPRING MD
20910-1460
US

IV. Provider business mailing address

1500 FOREST GLEN RD
SILVER SPRING MD
20910-1460
US

V. Phone/Fax

Practice location:
  • Phone: 301-754-7000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberD0106086
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberMD485973
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number0101291034
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: