Provider Demographics
NPI:1861851420
Name:OLUWADARE, AKINSOLA SESAN (HOME HEALTH AIDE)
Entity Type:Individual
Prefix:MR
First Name:AKINSOLA
Middle Name:SESAN
Last Name:OLUWADARE
Suffix:
Gender:M
Credentials:HOME HEALTH AIDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6315 LANDOVER ROAD APT 101
Mailing Address - Street 2:
Mailing Address - City:CHEVERLY
Mailing Address - State:MD
Mailing Address - Zip Code:20785
Mailing Address - Country:US
Mailing Address - Phone:240-906-0729
Mailing Address - Fax:
Practice Address - Street 1:1320 FORT STEVENS DR NW APT 5
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20011-5027
Practice Address - Country:US
Practice Address - Phone:202-520-9852
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-11
Last Update Date:2018-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA11693163WH0200X, 374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
No163WH0200XNursing Service ProvidersRegistered NurseHome Health