Provider Demographics
NPI:1003643040
Name:AFAMEFUNE, ALEXIS AYOMI (DPT, PT)
Entity type:Individual
Prefix:
First Name:ALEXIS
Middle Name:AYOMI
Last Name:AFAMEFUNE
Suffix:
Gender:F
Credentials:DPT, PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12217 CASTLE PINES DR
Mailing Address - Street 2:
Mailing Address - City:BELTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20705-1144
Mailing Address - Country:US
Mailing Address - Phone:240-460-7506
Mailing Address - Fax:
Practice Address - Street 1:55 W GUDE DR
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-1159
Practice Address - Country:US
Practice Address - Phone:240-614-2800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-16
Last Update Date:2024-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD30121225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist