Provider Demographics
NPI:1225682016
Name:AKINADE, OLUFEMI SAMUEL
Entity Type:Individual
Prefix:
First Name:OLUFEMI
Middle Name:SAMUEL
Last Name:AKINADE
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 1:120 CLOVERFIELD CT
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27127-9756
Mailing Address - Country:US
Mailing Address - Phone:336-926-9628
Mailing Address - Fax:
Practice Address - Street 1:120 CLOVERFIELD CT
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27127-9756
Practice Address - Country:US
Practice Address - Phone:336-926-9628
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-30
Last Update Date:2022-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician