MEDICARE: ADEYINKA WINDAPO

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	172A00000X	Driver
2	171W00000X	Contractor

General Provider Information

NPI Number	:	1679283782
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ADEYINKA WINDAPO

Provider Business Mailing Address
First Line	:	6400 BALTIMORE NATIONAL PIKE STE 250B
Second Line	:
City	:	CATONSVILLE
State	:	MD
Zip	:	21228-3947
Country	:	US
Telephone Number	:	410-227-7595
Fax Number	:

Provider Business Practice Location Address
First Line	:	6400 BALTIMORE NATIONAL PIKE STE 250B
Second Line	:
City	:	CATONSVILLE
State	:	MD
Zip	:	21228-3947
Country	:	US
Telephone Number	:	410-227-7595
Fax Number	:

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

Provider Enumeration Date	:	11/29/2022
Last Update Date	:	11/29/2022

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Directions to “ ADEYINKA WINDAPO ” Practice Location

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