MEDICARE: AVRM LLC

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	261QM2500X	Medical Specialty Clinic/Center	D0077960	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1972974376
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AVRM LLC

Provider Business Mailing Address
First Line	:	10750 COLUMBIA PIKE
Second Line	:	SUITE 220
City	:	SILVER SPRING
State	:	MD
Zip	:	20901-4402
Country	:	US
Telephone Number	:	301-328-7246
Fax Number	:	240-670-7284

Provider Business Practice Location Address
First Line	:	10750 COLUMBIA PIKE
Second Line	:	SUITE 220
City	:	SILVER SPRING
State	:	MD
Zip	:	20901-4402
Country	:	US
Telephone Number	:	301-328-7246
Fax Number	:	240-670-7284

Authorized Official
Title or Position	:	OWNER
Name	:	DR. TOLULOPE KOFI AKINYEMI
Credential	:	MD
Telephone Number	:	301-328-7246

Provider Enumeration Date	:	10/12/2015
Last Update Date	:	10/03/2016

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Directions to “AVRM LLC ” Practice Location

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