Provider Demographics
NPI:1215203872
Name:AKIWOWO, ABIMBOLA A (RPH)
Entity Type:Individual
Prefix:MRS
First Name:ABIMBOLA
Middle Name:A
Last Name:AKIWOWO
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9678 SUMMERLAKES DR
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-9393
Mailing Address - Country:US
Mailing Address - Phone:317-414-1377
Mailing Address - Fax:317-218-3020
Practice Address - Street 1:9678 SUMMERLAKES DR
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-9393
Practice Address - Country:US
Practice Address - Phone:317-414-1377
Practice Address - Fax:317-218-3020
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-28
Last Update Date:2012-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26015012A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist