Provider Demographics
NPI:1649367632
Name:AJANI, BABATUNDE MUSTAPHA (MD)
Entity type:Individual
Prefix:DR
First Name:BABATUNDE
Middle Name:MUSTAPHA
Last Name:AJANI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8118 GOOD LUCK RD
Mailing Address - Street 2:
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-3574
Mailing Address - Country:US
Mailing Address - Phone:301-552-8130
Mailing Address - Fax:301-552-8135
Practice Address - Street 1:2434 W BELVEDERE AVE
Practice Address - Street 2:LEVINDALE HEBREW GERIATRIC CENTER ATTN: MEDICAL OFFICE
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21215-5267
Practice Address - Country:US
Practice Address - Phone:410-601-2246
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2015-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0064533174400000X
MDD64533207R00000X, 207RH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine
No174400000XOther Service ProvidersSpecialist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILI09594Medicare UPIN
DC021982M58Medicare PIN