Provider Demographics
NPI:1083978621
Name:AKINSOWON, ADEYINKA T
Entity Type:Individual
Prefix:
First Name:ADEYINKA
Middle Name:T
Last Name:AKINSOWON
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 1:8505 FULTON AVE
Mailing Address - Street 2:
Mailing Address - City:GLENARDEN
Mailing Address - State:MD
Mailing Address - Zip Code:20706-1503
Mailing Address - Country:US
Mailing Address - Phone:301-917-4285
Mailing Address - Fax:
Practice Address - Street 1:8505 FULTON AVE
Practice Address - Street 2:
Practice Address - City:GLENARDEN
Practice Address - State:MD
Practice Address - Zip Code:20706-1503
Practice Address - Country:US
Practice Address - Phone:301-917-4285
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-28
Last Update Date:2012-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide