Provider Demographics
NPI:1558749366
Name:ADEMILUYI, FEMI LAWRENCE (DC)
Entity Type:Individual
Prefix:
First Name:FEMI
Middle Name:LAWRENCE
Last Name:ADEMILUYI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:FEMI
Other - Middle Name:
Other - Last Name:ADEMILUYI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:7843 RIVERDALE RD APT 202
Mailing Address - Street 2:
Mailing Address - City:NEW CARROLLTON
Mailing Address - State:MD
Mailing Address - Zip Code:20784-4025
Mailing Address - Country:US
Mailing Address - Phone:301-377-6649
Mailing Address - Fax:
Practice Address - Street 1:7843 RIVERDALE RD APT 202
Practice Address - Street 2:
Practice Address - City:NEW CARROLLTON
Practice Address - State:MD
Practice Address - Zip Code:20784-4025
Practice Address - Country:US
Practice Address - Phone:301-377-6649
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-13
Last Update Date:2015-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA10430374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCHHA10430Medicaid