Provider Demographics
NPI:1093242398
Name:PASCALL, AKILAH SAFIYA (MD)
Entity Type:Individual
Prefix:MS
First Name:AKILAH
Middle Name:SAFIYA
Last Name:PASCALL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2332 MASSANUTTEN DR
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20906-6168
Mailing Address - Country:US
Mailing Address - Phone:786-403-4566
Mailing Address - Fax:
Practice Address - Street 1:111 MICHIGAN AVE NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20010-2916
Practice Address - Country:US
Practice Address - Phone:786-403-4566
Practice Address - Fax:786-650-1104
Is Sole Proprietor?:No
Enumeration Date:2017-05-17
Last Update Date:2022-09-21
Deactivation Date:2017-12-18
Deactivation Code:
Reactivation Date:2018-11-21
Provider Licenses
StateLicense IDTaxonomies
390200000X
DCMD048027208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program