Provider Demographics
NPI:1689490252
Name:SHOLOYE, ADEBIMPE
Entity type:Individual
Prefix:
First Name:ADEBIMPE
Middle Name:
Last Name:SHOLOYE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9806 BROADMOOR TER
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20772-5358
Mailing Address - Country:US
Mailing Address - Phone:240-615-7042
Mailing Address - Fax:
Practice Address - Street 1:9806 BROADMOOR TER
Practice Address - Street 2:
Practice Address - City:UPPER MARLBORO
Practice Address - State:MD
Practice Address - Zip Code:20772-5358
Practice Address - Country:US
Practice Address - Phone:240-615-7042
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-28
Last Update Date:2024-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker
No171M00000XOther Service ProvidersCase Manager/Care Coordinator