Provider Demographics
NPI:1194904078
Name:RICHARD O AKOTO MD PA
Entity type:Organization
Organization Name:RICHARD O AKOTO MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:O
Authorized Official - Last Name:AKOTO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-681-9500
Mailing Address - Street 1:344 UNIVERSITY BLVD W STE 326
Mailing Address - Street 2:FOUR CORNERS MEDICAL CENTER
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20901-1971
Mailing Address - Country:US
Mailing Address - Phone:301-681-9500
Mailing Address - Fax:301-681-6570
Practice Address - Street 1:7610 CARROLL AVE STE 450
Practice Address - Street 2:
Practice Address - City:TAKOMA PARK
Practice Address - State:MD
Practice Address - Zip Code:20912-6324
Practice Address - Country:US
Practice Address - Phone:301-681-9500
Practice Address - Fax:301-681-6570
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-29
Last Update Date:2022-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0058683207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD438610800Medicaid
MDH67066Medicare UPIN
DCG01391Medicare PIN
MD438610800Medicaid