Provider Demographics
NPI:1538445598
Name:FAWEHINMI, FOLAYEMI
Entity type:Individual
Prefix:
First Name:FOLAYEMI
Middle Name:
Last Name:FAWEHINMI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:FOLAYEMI
Other - Middle Name:
Other - Last Name:AKINSIKU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9852 FAIRMONT AVE
Mailing Address - Street 2:
Mailing Address - City:MANASSAS
Mailing Address - State:VA
Mailing Address - Zip Code:20109-3176
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2101 FAIRLAND RD
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20904-5427
Practice Address - Country:US
Practice Address - Phone:301-388-4069
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-22
Last Update Date:2024-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD23015225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist