Provider Demographics
NPI:1477228112
Name:ADAKA, WISDOM NNAMDI (PHARMD, BCPS)
Entity Type:Individual
Prefix:MR
First Name:WISDOM
Middle Name:NNAMDI
Last Name:ADAKA
Suffix:
Gender:M
Credentials:PHARMD, BCPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5835 MOUNT VERNON DR
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22303-1923
Mailing Address - Country:US
Mailing Address - Phone:317-727-3037
Mailing Address - Fax:
Practice Address - Street 1:5835 MOUNT VERNON DR
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22303-1923
Practice Address - Country:US
Practice Address - Phone:317-727-3037
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-13
Last Update Date:2021-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA02022183481835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist