MEDICARE: DR. NELSON ADEREMI ALAWODE M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	D0028200	MD

General Provider Information

NPI Number	:	1912992017
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NELSON ADEREMI ALAWODE M.D.

Provider Business Mailing Address
First Line	:	3500 OLD WASHINGTON RD
Second Line	:	SUITE 302
City	:	WALDORF
State	:	MD
Zip	:	20602-3224
Country	:	US
Telephone Number	:	301-645-8867
Fax Number	:	301-645-2330

Provider Business Practice Location Address
First Line	:	3500 OLD WASHINGTON RD
Second Line	:	SUITE 302
City	:	WALDORF
State	:	MD
Zip	:	20602-3224
Country	:	US
Telephone Number	:	301-645-8867
Fax Number	:	301-645-2330

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/14/2005
Last Update Date	:	07/09/2007

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