Provider Demographics
NPI:1003640301
Name:AJOSE, MORILIAT OLAYINKA
Entity type:Individual
Prefix:
First Name:MORILIAT
Middle Name:OLAYINKA
Last Name:AJOSE
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3104 ALMA LN
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20716-3844
Mailing Address - Country:US
Mailing Address - Phone:240-412-2464
Mailing Address - Fax:
Practice Address - Street 1:8737 COLESVILLE RD STE 700
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-7901
Practice Address - Country:US
Practice Address - Phone:240-296-5858
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-28
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR224574363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health