Healthcare Provider Details

I. General information

NPI: 1225038649
Provider Name (Legal Business Name): AFOLABI O.D. AKINPELU M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2005
Last Update Date: 06/24/2025
Certification Date: 06/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17202 RIVA CT
ACCOKEEK MD
20607-3435
US

IV. Provider business mailing address

17202 RIVA CT
ACCOKEEK MD
20607-3435
US

V. Phone/Fax

Practice location:
  • Phone: 301-374-2225
  • Fax: 301-632-6990
Mailing address:
  • Phone: 301-374-2225
  • Fax: 301-632-6990

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberD58109
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number0101245805
License Number StateVA
# 3
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number21833
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: