Provider Demographics
NPI:1245764372
Name:OKANLAWON, AISAT (MD)
Entity Type:Individual
Prefix:
First Name:AISAT
Middle Name:
Last Name:OKANLAWON
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 1:4501 FORD AVE APT 514
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22302-1561
Mailing Address - Country:US
Mailing Address - Phone:410-371-6321
Mailing Address - Fax:
Practice Address - Street 1:4208 EVERGREEN LN STE 213
Practice Address - Street 2:
Practice Address - City:ANNANDALE
Practice Address - State:VA
Practice Address - Zip Code:22003-3254
Practice Address - Country:US
Practice Address - Phone:703-642-7522
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-14
Last Update Date:2021-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101272181207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology