Provider Demographics
NPI:1770468415
Name:DAVID, ANITA OLAJUMOKE
Entity type:Individual
Prefix:
First Name:ANITA
Middle Name:OLAJUMOKE
Last Name:DAVID
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 1:5610 HARFORD RD STE 306
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21214-2247
Mailing Address - Country:US
Mailing Address - Phone:667-381-9029
Mailing Address - Fax:
Practice Address - Street 1:5610 HARFORD RD STE 306
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21214-2247
Practice Address - Country:US
Practice Address - Phone:667-381-9029
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-11
Last Update Date:2025-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDRSA-03037251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health