Provider Demographics
NPI:1265270821
Name:AFOLABI, ABIMBOLA
Entity type:Individual
Prefix:MR
First Name:ABIMBOLA
Middle Name:
Last Name:AFOLABI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7982 INVERNESS RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:POTOMAC
Mailing Address - State:MD
Mailing Address - Zip Code:20854-4009
Mailing Address - Country:US
Mailing Address - Phone:202-515-8500
Mailing Address - Fax:
Practice Address - Street 1:7982 INVERNESS RIDGE RD
Practice Address - Street 2:
Practice Address - City:POTOMAC
Practice Address - State:MD
Practice Address - Zip Code:20854-4009
Practice Address - Country:US
Practice Address - Phone:202-515-8500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-17
Last Update Date:2024-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator