Provider Demographics
NPI:1194695619
Name:AWHANTO, OLUWATOYIN ADEJOKE
Entity type:Individual
Prefix:
First Name:OLUWATOYIN
Middle Name:ADEJOKE
Last Name:AWHANTO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1713 FOREST PARK DR
Mailing Address - Street 2:
Mailing Address - City:DISTRICT HEIGHTS
Mailing Address - State:MD
Mailing Address - Zip Code:20747-2619
Mailing Address - Country:US
Mailing Address - Phone:240-413-3455
Mailing Address - Fax:
Practice Address - Street 1:1713 FOREST PARK DR
Practice Address - Street 2:
Practice Address - City:DISTRICT HEIGHTS
Practice Address - State:MD
Practice Address - Zip Code:20747-2619
Practice Address - Country:US
Practice Address - Phone:240-413-3455
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-11-10
Last Update Date:2025-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide