Dr Olubode Olufajo, | |
5401 Old Court Rd, Randallstown, MD 21133-5103 | |
(410) 521-2200 | |
Not Available |
Full Name | Dr Olubode Olufajo |
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Gender | Male |
Speciality | Surgery |
Location | 5401 Old Court Rd, Randallstown, Maryland |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1942652458 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208600000X | Surgery | 2016012632 (Missouri) | Secondary |
208600000X | Surgery | D0086028 (Maryland) | Primary |
Entity Name | Northwest Hospital Center Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1508961988 PECOS PAC ID: 6204739352 Enrollment ID: O20040128000328 |
Mailing Address | Practice Location Address |
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Dr Olubode Olufajo, 2041 Georgia Ave, Department Of Surgery, Howard University Hospital, Washington, DC 20060-1010 Ph: (202) 865-7179 | Dr Olubode Olufajo, 5401 Old Court Rd, Randallstown, MD 21133-5103 Ph: (410) 521-2200 |
Brianne Elizabeth Leaf, PA-C Surgery Medicare: Accepting Medicare Assignments Practice Location: 5401 Old Court Rd, Randallstown, MD 21133 Phone: 410-521-2200 | |
Dr. Varughese Kuruvilla, M.D. Surgery Medicare: Not Enrolled in Medicare Practice Location: 5400 Old Court Rd, Suite 208, Randallstown, MD 21133 Phone: 410-561-0737 | |
Midori Pavielle Starks White, MD Surgery Medicare: Medicare Enrolled Practice Location: 5401 Old Court Rd, Randallstown, MD 21133 Phone: 410-521-2200 |