Provider Demographics
NPI:1558597120
Name:AKERELE, YOMI ADEWUNMI
Entity Type:Individual
Prefix:MR
First Name:YOMI
Middle Name:ADEWUNMI
Last Name:AKERELE
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 1:3200 GUMWOOD DR
Mailing Address - Street 2:#2125
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76014-2880
Mailing Address - Country:US
Mailing Address - Phone:972-814-5463
Mailing Address - Fax:817-375-8872
Practice Address - Street 1:3200 GUMWOOD DR
Practice Address - Street 2:#2125
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76014-2880
Practice Address - Country:US
Practice Address - Phone:972-814-5463
Practice Address - Fax:817-375-8872
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-09
Last Update Date:2009-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator