MEDICARE: ADIJAT TAIWO

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	376K00000X	Nurse's Aide	A00170228	MD

General Provider Information

NPI Number	:	1629704093
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ADIJAT TAIWO

Provider Business Mailing Address
First Line	:	2628 DEER RIDGE DR
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20904-7158
Country	:	US
Telephone Number	:	301-728-4151
Fax Number	:

Provider Business Practice Location Address
First Line	:	2628 DEER RIDGE DR
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20904-7158
Country	:	US
Telephone Number	:	301-728-4151
Fax Number	:

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

Provider Enumeration Date	:	07/28/2022
Last Update Date	:	07/28/2022

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Directions to “ ADIJAT TAIWO ” Practice Location

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