MEDICARE: OLUWADAMILOLA KOMOLAFE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1073468567
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	OLUWADAMILOLA KOMOLAFE

Provider Business Mailing Address
First Line	:	11409 BENNINGTON DR
Second Line	:
City	:	UPPER MARLBORO
State	:	MD
Zip	:	20774-5772
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1647 BENNING RD NE
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20002-4569
Country	:	US
Telephone Number	:	202-375-1532
Fax Number	:	202-375-1532

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/02/2026
Last Update Date	:	03/02/2026

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