Provider Demographics
NPI:1720812779
Name:ADEOSUN, TITILAYO (MD)
Entity type:Individual
Prefix:
First Name:TITILAYO
Middle Name:
Last Name:ADEOSUN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7916 DUNHILL VILLAGE CIR APT 202
Mailing Address - Street 2:
Mailing Address - City:WINDSOR MILL
Mailing Address - State:MD
Mailing Address - Zip Code:21244-4120
Mailing Address - Country:US
Mailing Address - Phone:443-325-2122
Mailing Address - Fax:
Practice Address - Street 1:7916 DUNHILL VILLAGE CIR APT 202
Practice Address - Street 2:
Practice Address - City:WINDSOR MILL
Practice Address - State:MD
Practice Address - Zip Code:21244-4120
Practice Address - Country:US
Practice Address - Phone:443-325-2122
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-30
Last Update Date:2024-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD020878253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care