MEDICARE: MR. DANIEL ADEYEMO

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	247200000X	Other Technician	MT0044255	MD

General Provider Information

NPI Number	:	1720411036
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. DANIEL ADEYEMO

Provider Business Mailing Address
First Line	:	8319 LIBERTY RD
Second Line	:
City	:	WINDSOR MILL
State	:	MD
Zip	:	21244-3127
Country	:	US
Telephone Number	:	443-271-4536
Fax Number	:	410-701-7375

Provider Business Practice Location Address
First Line	:	8319 LIBERTY RD
Second Line	:
City	:	WINDSOR MILL
State	:	MD
Zip	:	21244-3127
Country	:	US
Telephone Number	:	443-271-4536
Fax Number	:	410-701-7375

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

Provider Enumeration Date	:	08/10/2013
Last Update Date	:	08/10/2013

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