Provider Demographics
NPI:1205137635
Name:FADINA, FUNMILAYO (PHARM D)
Entity type:Individual
Prefix:DR
First Name:FUNMILAYO
Middle Name:
Last Name:FADINA
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 GENTLEBROOK RD
Mailing Address - Street 2:
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-2457
Mailing Address - Country:US
Mailing Address - Phone:443-904-3009
Mailing Address - Fax:
Practice Address - Street 1:225 GENTLEBROOK RD
Practice Address - Street 2:
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117-2457
Practice Address - Country:US
Practice Address - Phone:443-904-3009
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-17
Last Update Date:2021-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD18580183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist