Provider Demographics
NPI:1063775690
Name:AJAYI, ADEDAPO (MD)
Entity type:Individual
Prefix:
First Name:ADEDAPO
Middle Name:
Last Name:AJAYI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:DAPO
Other - Middle Name:
Other - Last Name:AJAYI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:10215 FERNWOOD RD STE 506
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20817-1184
Mailing Address - Country:US
Mailing Address - Phone:301-530-1010
Mailing Address - Fax:
Practice Address - Street 1:9601 BLACKWELL RD STE 100
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-6477
Practice Address - Country:US
Practice Address - Phone:301-940-9200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-19
Last Update Date:2022-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35131966207X00000X
390200000X
MDD86143207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program