Provider Demographics
NPI:1710321724
Name:FOLARANMI, SUPO AKINTUNDE (MD)
Entity Type:Individual
Prefix:DR
First Name:SUPO
Middle Name:AKINTUNDE
Last Name:FOLARANMI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:OLASUPO
Other - Middle Name:AKINTUNDE
Other - Last Name:FOLARANMI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2041 GEORGIA AVE. NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON DC
Mailing Address - State:DC
Mailing Address - Zip Code:20060-0001
Mailing Address - Country:US
Mailing Address - Phone:202-865-3290
Mailing Address - Fax:
Practice Address - Street 1:2041 GEORGIA AVE. NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON DC
Practice Address - State:DC
Practice Address - Zip Code:20060
Practice Address - Country:US
Practice Address - Phone:202-865-3290
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-21
Last Update Date:2018-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
OH35.131321207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program