Provider Demographics
NPI:1184263345
Name:SALIUOKEOLA, AMINA MOHAMMED
Entity type:Individual
Prefix:
First Name:AMINA
Middle Name:MOHAMMED
Last Name:SALIUOKEOLA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1302 QUIET LAKE CV
Mailing Address - Street 2:
Mailing Address - City:CROFTON
Mailing Address - State:MD
Mailing Address - Zip Code:21114-1876
Mailing Address - Country:US
Mailing Address - Phone:301-792-4853
Mailing Address - Fax:
Practice Address - Street 1:8201 ANNAPOLIS RD
Practice Address - Street 2:
Practice Address - City:NEW CARROLLTON
Practice Address - State:MD
Practice Address - Zip Code:20784-3016
Practice Address - Country:US
Practice Address - Phone:301-577-6222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-04
Last Update Date:2021-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDF12190698207Q00000X
MDR213314363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine