1952598526 NPI number — MS. SAUDAT OLAYINKA OLUSHOLA AKINOLA-HADLEY PA-C

Table of content: MS. SAUDAT OLAYINKA OLUSHOLA AKINOLA-HADLEY PA-C (NPI 1952598526)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1952598526 NPI number — MS. SAUDAT OLAYINKA OLUSHOLA AKINOLA-HADLEY PA-C

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
AKINOLA-HADLEY
Provider First Name:
SAUDAT OLAYINKA
Provider Middle Name:
OLUSHOLA
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
PA-C
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
AKINOLA-HADLEY
Provider Other First Name:
OLAYINKA
Provider Other Middle Name:
O
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
PA-C
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1952598526
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/23/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1525 14TH ST NW
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WASHINGTON
Provider Business Mailing Address State Name:
DC
Provider Business Mailing Address Postal Code:
20005-3706
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
202-745-7000
Provider Business Mailing Address Fax Number:
202-332-1049

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1525 14TH ST NW
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WASHINGTON
Provider Business Practice Location Address State Name:
DC
Provider Business Practice Location Address Postal Code:
20005-3706
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-752-0954
Provider Business Practice Location Address Fax Number:
410-752-7418
Provider Enumeration Date:
09/27/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363A00000X , with the licence number:  PA030968 , registered in the state of DC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 132190100 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".