Provider Demographics
NPI:1376933184
Name:ADEDOKUN, SULIAT
Entity Type:Individual
Prefix:
First Name:SULIAT
Middle Name:
Last Name:ADEDOKUN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6309 RORY CT
Mailing Address - Street 2:
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-2478
Mailing Address - Country:US
Mailing Address - Phone:240-330-3742
Mailing Address - Fax:
Practice Address - Street 1:6309 RORY CT
Practice Address - Street 2:
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-2478
Practice Address - Country:US
Practice Address - Phone:240-330-3742
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-01
Last Update Date:2015-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0230025451183700000X
AZT044261183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician