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General NPI Number Information
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NPI Number | 1760989628
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Entity Type | Individual
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Provider Name | OLUWAFUNMILAYO IFEOLU ATANDA MD
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Gender | Female
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Dates
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Enumeration Date | 04/09/2018
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Last Update Date | 03/31/2023
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Provider Practice Location Address
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Address Line | 2041 GEORGIA AVENUE NW
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City | WASHINGTON
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State | DC
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Zip | 20059-0001
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Country | US
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Telephone | 202-865-6100
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Fax |
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Provider Business Mailing Address
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Address Line | 205 ROLLINS AVE
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City | ROCKVILLE
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State | MD
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Zip | 20852-4011
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Country | US
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Telephone | 240-615-7667
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 0101277867
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License Number State | VA
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