Healthcare Provider Details

I. General information

NPI: 1174106991
Provider Name (Legal Business Name): LILIAN ADAMU
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/29/2021
Last Update Date: 07/26/2021
Certification Date: 07/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1060 W PERIMETER RD
JB ANDREWS MD
20762-6602
US

IV. Provider business mailing address

2823 MILL ISLAND PKWY
FREDERICK MD
21701-6620
US

V. Phone/Fax

Practice location:
  • Phone: 240-612-1262
  • Fax:
Mailing address:
  • Phone: 240-593-2421
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberR193515
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberR193515
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: