Healthcare Provider Details

I. General information

NPI: 1285998823
Provider Name (Legal Business Name): ELIZABETH O AINA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2012
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13102 5TH ST APT 3
BOWIE MD
20720-3667
US

IV. Provider business mailing address

13102 5TH ST
BOWIE MD
20720-3667
US

V. Phone/Fax

Practice location:
  • Phone: 240-605-6728
  • Fax:
Mailing address:
  • Phone: 240-605-6728
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: