Provider Demographics
NPI:1013525252
Name:ADELAKUN, ADESOJI BABATUNDE
Entity type:Individual
Prefix:
First Name:ADESOJI
Middle Name:BABATUNDE
Last Name:ADELAKUN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:922 5TH ST
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20707-5106
Mailing Address - Country:US
Mailing Address - Phone:443-975-5408
Mailing Address - Fax:
Practice Address - Street 1:922 5TH ST
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20707-5106
Practice Address - Country:US
Practice Address - Phone:443-975-5408
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-14
Last Update Date:2020-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD25646183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist