Healthcare Provider Details

I. General information

NPI: 1154241677
Provider Name (Legal Business Name): OLUFEMI PETERS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/16/2026
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 PA AVE SE STE 210
WASHINGTON DC
20003-4344
US

IV. Provider business mailing address

14139 CASTLE BLVD APT 202
SILVER SPRING MD
20904-4745
US

V. Phone/Fax

Practice location:
  • Phone: 202-282-3004
  • Fax: 202-282-2057
Mailing address:
  • Phone: 202-282-3004
  • Fax: 202-282-2057

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License NumberHHA200006009
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: