Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 57.014619 | OH |
Y | 207X00000X | Orthopaedic Surgeon | D91700 | MD |
N | 207XS0106X | Orthopaedic Hand Surgeon | ME121700 | FL |
NPI | 1023268620 |
---|---|
Provider Name | Dr. Olukemi Kay Fajolu |
First Address | Middle River, MD 21220-2004 |
Second Address | Columbia, MD 21044-3687 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/09/2008 |
Last Update Date | 17/08/2021 |