Provider Demographics
NPI:1891766309
Name:AKINWANDE, AKINDOLAPO O (MD)
Entity Type:Individual
Prefix:DR
First Name:AKINDOLAPO
Middle Name:O
Last Name:AKINWANDE
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 1:1935 N CAPITOL AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46202-6403
Mailing Address - Country:US
Mailing Address - Phone:317-931-3252
Mailing Address - Fax:317-931-3255
Practice Address - Street 1:1935 N CAPITOL AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46202-6403
Practice Address - Country:US
Practice Address - Phone:317-931-3252
Practice Address - Fax:317-931-3255
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-01
Last Update Date:2021-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01056710A207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200416380AMedicaid
IN200416380AMedicaid
IN264950AMedicare PIN
IN264950Medicare PIN