Provider Demographics
NPI:1639576358
Name:ALPHA POINT MEDICAL LLC
Entity Type:Organization
Organization Name:ALPHA POINT MEDICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ADEBOWALE
Authorized Official - Middle Name:I
Authorized Official - Last Name:AJAYI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-313-9013
Mailing Address - Street 1:PO BOX 507
Mailing Address - Street 2:
Mailing Address - City:FULTON
Mailing Address - State:MD
Mailing Address - Zip Code:20759-0507
Mailing Address - Country:US
Mailing Address - Phone:301-313-9013
Mailing Address - Fax:301-313-9015
Practice Address - Street 1:6201 GREENBELT RD
Practice Address - Street 2:SUITE M8B
Practice Address - City:BERWYN HEIGHTS
Practice Address - State:MD
Practice Address - Zip Code:20740-2354
Practice Address - Country:US
Practice Address - Phone:301-313-9013
Practice Address - Fax:301-313-9015
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-24
Last Update Date:2014-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD45217207R00000X
MDR118268363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty