Provider Demographics
NPI:1952506677
Name:NELSON A. ALAWODE, M.D., P.C.
Entity Type:Organization
Organization Name:NELSON A. ALAWODE, M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:NELSON
Authorized Official - Middle Name:ADEREMI
Authorized Official - Last Name:ALAWODE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-645-8867
Mailing Address - Street 1:3500 OLD WASHINGTON RD
Mailing Address - Street 2:SUITE 302
Mailing Address - City:WALDORF
Mailing Address - State:MD
Mailing Address - Zip Code:20602-3224
Mailing Address - Country:US
Mailing Address - Phone:301-645-8867
Mailing Address - Fax:301-645-2330
Practice Address - Street 1:3500 OLD WASHINGTON RD
Practice Address - Street 2:SUITE 302
Practice Address - City:WALDORF
Practice Address - State:MD
Practice Address - Zip Code:20602-3224
Practice Address - Country:US
Practice Address - Phone:301-645-8867
Practice Address - Fax:301-645-2330
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0028200207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDB69949Medicare UPIN
MDG01174Medicare ID - Type UnspecifiedPG COUNTY
MD569MMedicare ID - Type UnspecifiedCHARLES COUNTY