Provider Demographics
NPI:1952598526
Name:AKINOLA-HADLEY, SAUDAT OLAYINKA OLUSHOLA (PA-C)
Entity Type:Individual
Prefix:MS
First Name:SAUDAT OLAYINKA
Middle Name:OLUSHOLA
Last Name:AKINOLA-HADLEY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MS
Other - First Name:OLAYINKA
Other - Middle Name:O
Other - Last Name:AKINOLA-HADLEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PA-C
Mailing Address - Street 1:1525 14TH ST NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20005-3706
Mailing Address - Country:US
Mailing Address - Phone:202-745-7000
Mailing Address - Fax:202-332-1049
Practice Address - Street 1:1525 14TH ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20005-3706
Practice Address - Country:US
Practice Address - Phone:410-752-0954
Practice Address - Fax:410-752-7418
Is Sole Proprietor?:No
Enumeration Date:2007-09-27
Last Update Date:2019-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPA030968363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD132190100Medicaid
MD132190100Medicaid
MD211819Medicare Oscar/Certification
MD239965YVZMedicare PIN
MD239966ZDDBMedicare PIN
MDOTH000Medicare UPIN
MDS357Medicare PIN