Provider Demographics
NPI:1083262455
Name:ADEYEMO, AKINOLA E
Entity Type:Individual
Prefix:
First Name:AKINOLA
Middle Name:E
Last Name:ADEYEMO
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 1:9331 LANHAM SEVERN RD
Mailing Address - Street 2:
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-2730
Mailing Address - Country:US
Mailing Address - Phone:240-422-4181
Mailing Address - Fax:
Practice Address - Street 1:9001 WOODY TER
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:MD
Practice Address - Zip Code:20735-4255
Practice Address - Country:US
Practice Address - Phone:301-856-6501
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-29
Last Update Date:2019-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD26576183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist