Provider Demographics
NPI:1659859304
Name:ADEWUNMI, KEHINDE O (RPH)
Entity Type:Individual
Prefix:MR
First Name:KEHINDE
Middle Name:O
Last Name:ADEWUNMI
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3513 65TH AVE
Mailing Address - Street 2:
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20784-2465
Mailing Address - Country:US
Mailing Address - Phone:240-893-4365
Mailing Address - Fax:
Practice Address - Street 1:20908 FREDERICK RD
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:MD
Practice Address - Zip Code:20876-4134
Practice Address - Country:US
Practice Address - Phone:301-515-0326
Practice Address - Fax:301-944-0326
Is Sole Proprietor?:No
Enumeration Date:2018-08-03
Last Update Date:2018-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD25667183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist