Healthcare Provider Details

I. General information

NPI: 1154760734
Provider Name (Legal Business Name): OLADIMEJI AKINOLA AKINBORO M.D., M.P.H
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/18/2013
Last Update Date: 04/14/2026
Certification Date: 04/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10903 NEW HAMPSHIRE AVE BLDG 22
SILVER SPRING MD
20993-0002
US

IV. Provider business mailing address

820 HARRISON AVE
BOSTON MA
02118-2905
US

V. Phone/Fax

Practice location:
  • Phone: 817-317-1540
  • Fax:
Mailing address:
  • Phone: 817-317-1540
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number287574
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207RH0000X
TaxonomyHematology (Internal Medicine) Physician
License Number287574
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number287574
License Number StateNY
# 4
Primary TaxonomyN
Taxonomy Code171000000X
TaxonomyMilitary Health Care Provider
License Number287574
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: