MEDICARE: DR. ADETEJU OGUNRINDE M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	D47254	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	1548544992	OTHER	MD	NATIONAL NPI -PRACTICE
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1083711733
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ADETEJU OGUNRINDE M.D.

Provider Business Mailing Address
First Line	:	605 POST OFFICE RD
Second Line	:	SUITE 102
City	:	WALDORF
State	:	MD
Zip	:	20602-1913
Country	:	US
Telephone Number	:	301-870-1789
Fax Number	:	301-374-2662

Provider Business Practice Location Address
First Line	:	605 POST OFFICE RD
Second Line	:	SUITE 102
City	:	WALDORF
State	:	MD
Zip	:	20602-1913
Country	:	US
Telephone Number	:	301-870-1789
Fax Number	:	301-374-2662

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/17/2006
Last Update Date	:	11/07/2012

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