Provider Demographics
NPI:1912017690
Name:OLUWEHINMI, FOLA (MD)
Entity Type:Individual
Prefix:
First Name:FOLA
Middle Name:
Last Name:OLUWEHINMI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:FOLA
Other - Middle Name:
Other - Last Name:FAWEHINMI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3022 WILLIAMS DR STE 300
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22031-4600
Mailing Address - Country:US
Mailing Address - Phone:703-573-9800
Mailing Address - Fax:703-573-2959
Practice Address - Street 1:3022 WILLIAMS DR STE 300
Practice Address - Street 2:INTERNAL MEDICINE/GERIATRICS
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031-4600
Practice Address - Country:US
Practice Address - Phone:703-573-9800
Practice Address - Fax:703-573-2959
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101253418207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
H71566Medicare UPIN