Provider Demographics
NPI:1891883054
Name:AYENI, SYLVANUS A (MD)
Entity Type:Individual
Prefix:
First Name:SYLVANUS
Middle Name:A
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 1:8830 CAMERON ST
Mailing Address - Street 2:#305
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-4155
Mailing Address - Country:US
Mailing Address - Phone:301-588-4460
Mailing Address - Fax:301-588-6053
Practice Address - Street 1:8830 CAMERON ST
Practice Address - Street 2:#305
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-4155
Practice Address - Country:US
Practice Address - Phone:301-588-4460
Practice Address - Fax:301-588-6053
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-11
Last Update Date:2008-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD20278207T00000X
MDD00481202207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDE04581Medicare UPIN
DC165890Medicare ID - Type Unspecified
DC165890Medicare PIN