Healthcare Provider Details

I. General information

NPI: 1770803504
Provider Name (Legal Business Name): ADEKEMI AKINGBOYE HARVEY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ADEKEMI OLUFUNMILAYO AKINGBOYE MD

II. Dates (important events)

Enumeration Date: 06/03/2010
Last Update Date: 09/12/2023
Certification Date: 09/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10910 LITTLE PATUXENT PKWY STE 205
COLUMBIA MD
21044-3092
US

IV. Provider business mailing address

801 YORK ST
MANITOWOC WI
54220-4630
US

V. Phone/Fax

Practice location:
  • Phone: 410-772-0707
  • Fax: 410-772-5654
Mailing address:
  • Phone: 920-663-9008
  • Fax: 920-684-1439

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberD80113
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberM86649
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: