Provider Demographics
NPI:1821167149
Name:AYENI, AKINLAWON OLUGBENGA (MD)
Entity Type:Individual
Prefix:MR
First Name:AKINLAWON
Middle Name:OLUGBENGA
Last Name:AYENI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7137 FOX HARBOR WAY
Mailing Address - Street 2:
Mailing Address - City:ELKRIDGE
Mailing Address - State:MD
Mailing Address - Zip Code:21075-6570
Mailing Address - Country:US
Mailing Address - Phone:410-379-8380
Mailing Address - Fax:301-925-4463
Practice Address - Street 1:1400 MERCANTILE LN STE 180
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:MD
Practice Address - Zip Code:20774-5369
Practice Address - Country:US
Practice Address - Phone:301-925-7022
Practice Address - Fax:301-925-4463
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-08
Last Update Date:2022-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
173000000X
GA266992084A0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084A0401XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction MedicineGroup - Single Specialty
No173000000XOther Service ProvidersLegal MedicineGroup - Single Specialty