Provider Demographics
NPI:1629776471
Name:WALE-AREMU, DAMILOLA ADEDOYIN
Entity type:Individual
Prefix:
First Name:DAMILOLA
Middle Name:ADEDOYIN
Last Name:WALE-AREMU
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 1:8963 CENTERWAY RD
Mailing Address - Street 2:
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20879-1802
Mailing Address - Country:US
Mailing Address - Phone:240-552-0083
Mailing Address - Fax:
Practice Address - Street 1:8963 CENTERWAY RD
Practice Address - Street 2:
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20879-1802
Practice Address - Country:US
Practice Address - Phone:240-552-0083
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-21
Last Update Date:2023-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR241266163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse