Healthcare Provider Details

I. General information

NPI: 1699961912
Provider Name (Legal Business Name): DIANE AKINYELU PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2007
Last Update Date: 05/22/2026
Certification Date: 05/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17351 MELFORD BLVD
BOWIE MD
20715-4457
US

IV. Provider business mailing address

411 OAK ST ATTN: CREDENTIALS
CINCINNATI OH
45219-2504
US

V. Phone/Fax

Practice location:
  • Phone: 240-604-6172
  • Fax:
Mailing address:
  • Phone: 513-984-1800
  • Fax: 513-984-4909

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number17010
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: