Provider Demographics
NPI:1548544992
Name:ADETEJU OGUNRINDE, MD, F.A.A.P., CHILDREN'S HEALTH CARE CTR.
Entity type:Organization
Organization Name:ADETEJU OGUNRINDE, MD, F.A.A.P., CHILDREN'S HEALTH CARE CTR.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ADETEJU
Authorized Official - Middle Name:B
Authorized Official - Last Name:OGUNRINDE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-870-1789
Mailing Address - Street 1:605 POST OFFICE ROAD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:WALDORF
Mailing Address - State:MD
Mailing Address - Zip Code:20602
Mailing Address - Country:US
Mailing Address - Phone:301-870-1789
Mailing Address - Fax:
Practice Address - Street 1:605 POST OFFICE ROAD
Practice Address - Street 2:SUITE 102
Practice Address - City:WALDORF
Practice Address - State:MD
Practice Address - Zip Code:20602
Practice Address - Country:US
Practice Address - Phone:301-870-1789
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-04
Last Update Date:2012-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD1083711733OtherPERSONAL NPI
MD224416100Medicaid
MD359185900Medicaid
MD224416100Medicaid