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General NPI Number Information
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NPI Number | 1972701761
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Entity Type | Individual
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Provider Name | ADEGBOYEGA A OYEMADE MD
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Gender | Male
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Dates
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Enumeration Date | 07/03/2007
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Last Update Date | 04/25/2024
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Provider Practice Location Address
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Address Line | 7141 SECURITY BLVD
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City | BALTIMORE
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State | MD
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Zip | 21244-1800
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Country | US
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Telephone | 443-663-6329
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Fax | 443-663-6026
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Provider Business Mailing Address
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Address Line | 10128 BRACKEN DR
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City | ELLICOTT CITY
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State | MD
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Zip | 21042-1673
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Country | US
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Telephone | 443-542-9121
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | D0074799
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 2084P0802X
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Taxonomy Name | Addiction Psychiatry Physician
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License Number | D0074799
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License Number State | MD
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Taxonomy #3
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 036-117118
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License Number State | IL
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