Provider Demographics
NPI:1659854602
Name:AKINWUMI, OLUWABUSAYOMI MARYJOY
Entity type:Individual
Prefix:
First Name:OLUWABUSAYOMI
Middle Name:MARYJOY
Last Name:AKINWUMI
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 1:3714 HARMON AVE
Mailing Address - Street 2:
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20784-2402
Mailing Address - Country:US
Mailing Address - Phone:240-334-8774
Mailing Address - Fax:
Practice Address - Street 1:3714 HARMON AVE
Practice Address - Street 2:
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20784-2402
Practice Address - Country:US
Practice Address - Phone:240-334-8774
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-14
Last Update Date:2018-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA12007374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide