Provider Demographics
NPI:1134838907
Name:BRITT, ADEBOLA ABIODUN (NP)
Entity type:Individual
Prefix:
First Name:ADEBOLA
Middle Name:ABIODUN
Last Name:BRITT
Suffix:
Gender:
Credentials:NP
Other - Prefix:
Other - First Name:ADEBOLA
Other - Middle Name:ABIODUN
Other - Last Name:SONUGA-BRITT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:6305 IVY LN STE 205
Mailing Address - Street 2:
Mailing Address - City:GREENBELT
Mailing Address - State:MD
Mailing Address - Zip Code:20770-6355
Mailing Address - Country:US
Mailing Address - Phone:240-328-7565
Mailing Address - Fax:
Practice Address - Street 1:6305 IVY LN STE 205
Practice Address - Street 2:
Practice Address - City:GREENBELT
Practice Address - State:MD
Practice Address - Zip Code:20770-6355
Practice Address - Country:US
Practice Address - Phone:240-328-7565
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-21
Last Update Date:2025-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR196976363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health