Provider Demographics
NPI:1326273152
Name:ATEWOLOGUN, ADEFOLAKE AYOTUNDE (MD)
Entity type:Individual
Prefix:DR
First Name:ADEFOLAKE
Middle Name:AYOTUNDE
Last Name:ATEWOLOGUN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ADEFOLAKE
Other - Middle Name:
Other - Last Name:OSHODI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1011 HAVENCREST ST
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850
Mailing Address - Country:US
Mailing Address - Phone:646-425-3300
Mailing Address - Fax:
Practice Address - Street 1:131 ELDEN ST
Practice Address - Street 2:
Practice Address - City:HERNDON
Practice Address - State:VA
Practice Address - Zip Code:20170
Practice Address - Country:US
Practice Address - Phone:646-425-3300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-22
Last Update Date:2024-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY251761-12084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry