Provider Demographics
NPI:1750642369
Name:ADEWALE, RACHEL O
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:O
Last Name:ADEWALE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:710 CAMELOT WAY
Mailing Address - Street 2:
Mailing Address - City:FORT WASHINGTON
Mailing Address - State:MD
Mailing Address - Zip Code:20744-5641
Mailing Address - Country:US
Mailing Address - Phone:301-535-6452
Mailing Address - Fax:
Practice Address - Street 1:710 CAMELOT WAY
Practice Address - Street 2:
Practice Address - City:FORT WASHINGTON
Practice Address - State:MD
Practice Address - Zip Code:20744-5641
Practice Address - Country:US
Practice Address - Phone:301-535-6452
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-31
Last Update Date:2012-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide