Provider Demographics
NPI:1861752693
Name:AKINOLA, EKUNDAYO KHADIJAT
Entity type:Individual
Prefix:
First Name:EKUNDAYO
Middle Name:KHADIJAT
Last Name:AKINOLA
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 1:12318 JAMES MADISON LN
Mailing Address - Street 2:
Mailing Address - City:GLENN DALE
Mailing Address - State:MD
Mailing Address - Zip Code:20769-9169
Mailing Address - Country:US
Mailing Address - Phone:202-277-7601
Mailing Address - Fax:
Practice Address - Street 1:12318 JAMES MADISON LN
Practice Address - Street 2:
Practice Address - City:GLENN DALE
Practice Address - State:MD
Practice Address - Zip Code:20769-9169
Practice Address - Country:US
Practice Address - Phone:202-277-7601
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-27
Last Update Date:2012-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator