Provider Demographics
NPI:1588149520
Name:OJEYINKA, WALE J (NP)
Entity type:Individual
Prefix:MR
First Name:WALE
Middle Name:J
Last Name:OJEYINKA
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4209 QUANDERS PROMISE DR
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20720-4693
Mailing Address - Country:US
Mailing Address - Phone:240-603-7675
Mailing Address - Fax:
Practice Address - Street 1:4209 QUANDERS PROMISE DR
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20720-4693
Practice Address - Country:US
Practice Address - Phone:301-877-5677
Practice Address - Fax:301-877-5680
Is Sole Proprietor?:No
Enumeration Date:2018-09-25
Last Update Date:2020-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCRN1018367363LA2100X
MDR198104363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care