Provider Demographics
NPI:1114033743
Name:KOSO-THOMAS, AKINTUNDE KAI (MD)
Entity Type:Individual
Prefix:DR
First Name:AKINTUNDE
Middle Name:KAI
Last Name:KOSO-THOMAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:16640 EMORY LN
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20853-1230
Mailing Address - Country:US
Mailing Address - Phone:301-602-4741
Mailing Address - Fax:202-204-8599
Practice Address - Street 1:7500 GREENWAY CENTER DR
Practice Address - Street 2:8TH FLOOR
Practice Address - City:GREENBELT
Practice Address - State:MD
Practice Address - Zip Code:20770-3502
Practice Address - Country:US
Practice Address - Phone:301-477-2000
Practice Address - Fax:301-474-2389
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2013-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0055514207ZP0102X
NJ25MA08107800207ZP0102X
NY241316207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY3RR9239931Medicare PIN