Provider Demographics
NPI:1376361964
Name:ADEBISI, AFOLAKE
Entity type:Individual
Prefix:
First Name:AFOLAKE
Middle Name:
Last Name:ADEBISI
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 1:8621 SHERWOOD GLN
Mailing Address - Street 2:
Mailing Address - City:JESSUP
Mailing Address - State:MD
Mailing Address - Zip Code:20794-9241
Mailing Address - Country:US
Mailing Address - Phone:240-608-9727
Mailing Address - Fax:
Practice Address - Street 1:8621 SHERWOOD GLN
Practice Address - Street 2:
Practice Address - City:JESSUP
Practice Address - State:MD
Practice Address - Zip Code:20794-9241
Practice Address - Country:US
Practice Address - Phone:240-608-9727
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-01
Last Update Date:2024-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD176637183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist