Healthcare Provider Details

I. General information

NPI: 1841921764
Provider Name (Legal Business Name): ABIODUN ADELOLA AKINKUGBE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2022
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2512 24TH ST NE
WASHINGTON DC
20018-2126
US

IV. Provider business mailing address

604 DRUMSHEUGH CT
UPPER MARLBORO MD
20774-5751
US

V. Phone/Fax

Practice location:
  • Phone: 202-832-8340
  • Fax:
Mailing address:
  • Phone: 240-302-0286
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License NumberA00201236
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: