Provider Demographics
NPI:1629949623
Name:OKUNUGA, BABATUNDE AYODELE
Entity type:Individual
Prefix:
First Name:BABATUNDE
Middle Name:AYODELE
Last Name:OKUNUGA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7894 PEPPERBOX LN
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:MD
Mailing Address - Zip Code:21122-6372
Mailing Address - Country:US
Mailing Address - Phone:929-499-4329
Mailing Address - Fax:
Practice Address - Street 1:7211 PARK HEIGHTS AVE STE 4
Practice Address - Street 2:
Practice Address - City:PIKESVILLE
Practice Address - State:MD
Practice Address - Zip Code:21208-5497
Practice Address - Country:US
Practice Address - Phone:443-759-8965
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-15
Last Update Date:2025-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty