Provider Demographics
NPI:1346008562
Name:AKINKUOTU, SAMSON
Entity Type:Individual
Prefix:
First Name:SAMSON
Middle Name:
Last Name:AKINKUOTU
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 1:4808 WILD HORSE CT
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20772-3178
Mailing Address - Country:US
Mailing Address - Phone:240-556-7182
Mailing Address - Fax:
Practice Address - Street 1:4808 WILD HORSE CT
Practice Address - Street 2:
Practice Address - City:UPPER MARLBORO
Practice Address - State:MD
Practice Address - Zip Code:20772-3178
Practice Address - Country:US
Practice Address - Phone:240-556-7182
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-12
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide