Provider Demographics
NPI:1427659176
Name:BANJOKO, ADETOKUNBO TAOFIK
Entity type:Individual
Prefix:
First Name:ADETOKUNBO
Middle Name:TAOFIK
Last Name:BANJOKO
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 1:7074 ALLENTOWN RD
Mailing Address - Street 2:
Mailing Address - City:CAMP SPRINGS
Mailing Address - State:MD
Mailing Address - Zip Code:20748-5333
Mailing Address - Country:US
Mailing Address - Phone:301-449-7483
Mailing Address - Fax:
Practice Address - Street 1:7074 ALLENTOWN RD
Practice Address - Street 2:
Practice Address - City:CAMP SPRINGS
Practice Address - State:MD
Practice Address - Zip Code:20748-5333
Practice Address - Country:US
Practice Address - Phone:301-449-7483
Practice Address - Fax:844-411-6238
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-07
Last Update Date:2020-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD17103183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist