Provider Demographics
NPI:1912992017
Name:ALAWODE, NELSON ADEREMI (MD)
Entity Type:Individual
Prefix:DR
First Name:NELSON
Middle Name:ADEREMI
Last Name:ALAWODE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3500 OLD WASHINGTON RD
Mailing Address - Street 2:SUITE 302
Mailing Address - City:WALDORF
Mailing Address - State:MD
Mailing Address - Zip Code:20602-3224
Mailing Address - Country:US
Mailing Address - Phone:301-645-8867
Mailing Address - Fax:301-645-2330
Practice Address - Street 1:3500 OLD WASHINGTON RD
Practice Address - Street 2:SUITE 302
Practice Address - City:WALDORF
Practice Address - State:MD
Practice Address - Zip Code:20602-3224
Practice Address - Country:US
Practice Address - Phone:301-645-8867
Practice Address - Fax:301-645-2330
Is Sole Proprietor?:No
Enumeration Date:2005-09-14
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0028200207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD00B771N74Medicare ID - Type UnspecifiedPG COUNTY IND.
MDG01174Medicare ID - Type UnspecifiedPG COUNTY GROUP NUM.
MD569M883FMedicare ID - Type UnspecifiedIND. NUMBER CHARLES CO.
MDB69949Medicare UPIN
MD569MMedicare ID - Type UnspecifiedGROUP # CHARLES COUNTY