Provider Demographics
NPI:1639439623
Name:ATTE, AKERE CHONGWAIN (MD, PHARMD)
Entity Type:Individual
Prefix:
First Name:AKERE
Middle Name:CHONGWAIN
Last Name:ATTE
Suffix:
Gender:M
Credentials:MD, PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7950 SW 30TH ST STE 201
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33328-1979
Mailing Address - Country:US
Mailing Address - Phone:754-356-8300
Mailing Address - Fax:833-954-4041
Practice Address - Street 1:7950 SW 30TH ST STE 201
Practice Address - Street 2:
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33328-1979
Practice Address - Country:US
Practice Address - Phone:754-356-8300
Practice Address - Fax:833-954-4041
Is Sole Proprietor?:No
Enumeration Date:2012-05-23
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME150675207X00000X, 207XX0005X, 207XX0005X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine