Healthcare Provider Details

I. General information

NPI: 1114427440
Provider Name (Legal Business Name): TOLU ARIYO AKINMADE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/13/2018
Last Update Date: 08/31/2022
Certification Date: 08/31/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2401 BLUERIDGE AVE STE 210
SILVER SPRING MD
20902-4517
US

IV. Provider business mailing address

2401 BLUERIDGE AVE STE 210
SILVER SPRING MD
20902-4517
US

V. Phone/Fax

Practice location:
  • Phone: 301-933-6440
  • Fax: 301-933-5923
Mailing address:
  • Phone: 301-933-6440
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberD0089384
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: