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NPI Code Detail

MEDICARE: DAMILOLA BEN FUNMILAYO PA

MEDICARE: DAMILOLA BEN FUNMILAYO PA
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
1207RC0200XCritical Care Medicine (Internal Medicine) PhysicianC0010162MD

General Provider Information

NPI Number : 1891591509
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAMILOLA BEN FUNMILAYO PA
Provider Business Mailing Address
First Line : 110 IRVING ST NW STE 2A38M
Second Line :
City : WASHINGTON
State : DC
Zip : 20010-3017
Country : US
Telephone Number : 202-877-4677
Fax Number :
Provider Business Practice Location Address
First Line : 18101 PRINCE PHILIP DR
Second Line :
City : OLNEY
State : MD
Zip : 20832-1514
Country : US
Telephone Number : 301-774-8882
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/22/2025
Last Update Date : 02/25/2026

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Directions to “ DAMILOLA BEN FUNMILAYO PA” Practice Location

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