Provider Demographics
NPI:1063012631
Name:AINA, OLAWUNMI
Entity Type:Individual
Prefix:DR
First Name:OLAWUNMI
Middle Name:
Last Name:AINA
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 1:1009 FAIRLAWN AVE
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20707-4807
Mailing Address - Country:US
Mailing Address - Phone:301-498-9337
Mailing Address - Fax:844-411-6315
Practice Address - Street 1:1009 FAIRLAWN AVE
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20707-4807
Practice Address - Country:US
Practice Address - Phone:301-498-9337
Practice Address - Fax:844-411-6315
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-31
Last Update Date:2020-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD20876183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist