Provider Demographics
NPI:1669059648
Name:SADIQ, SABIK AYOKUNLE (FNP -BC)
Entity type:Individual
Prefix:MR
First Name:SABIK
Middle Name:AYOKUNLE
Last Name:SADIQ
Suffix:
Gender:M
Credentials:FNP -BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6222 AUTH RD
Mailing Address - Street 2:
Mailing Address - City:SUITLAND
Mailing Address - State:MD
Mailing Address - Zip Code:20746-4506
Mailing Address - Country:US
Mailing Address - Phone:240-461-8265
Mailing Address - Fax:
Practice Address - Street 1:6222 AUTH RD
Practice Address - Street 2:
Practice Address - City:SUITLAND
Practice Address - State:MD
Practice Address - Zip Code:20746-4506
Practice Address - Country:US
Practice Address - Phone:240-461-8265
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-26
Last Update Date:2021-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR205717363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty