Provider Demographics
NPI:1497976815
Name:ADEBOHUN, ADEBO ABDUR-RATSHID (RPT)
Entity Type:Individual
Prefix:
First Name:ADEBO
Middle Name:ABDUR-RATSHID
Last Name:ADEBOHUN
Suffix:
Gender:M
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3617 SHENANDOAH DR
Mailing Address - Street 2:
Mailing Address - City:BELTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20705-3549
Mailing Address - Country:US
Mailing Address - Phone:301-595-8260
Mailing Address - Fax:301-595-8260
Practice Address - Street 1:4000 ALBEMARLE ST NW
Practice Address - Street 2:SUITE 210
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20016-1851
Practice Address - Country:US
Practice Address - Phone:202-363-0130
Practice Address - Fax:202-363-0376
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPT24232251G0304X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics