Provider Demographics
NPI:1346070067
Name:SAMUEL, AREMU KUNMI
Entity type:Individual
Prefix:
First Name:AREMU
Middle Name:KUNMI
Last Name:SAMUEL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7512 BRYANTOWN LN
Mailing Address - Street 2:
Mailing Address - City:BRANDYWINE
Mailing Address - State:MD
Mailing Address - Zip Code:20613-5948
Mailing Address - Country:US
Mailing Address - Phone:202-751-9481
Mailing Address - Fax:
Practice Address - Street 1:7512 BRYANTOWN LN
Practice Address - Street 2:
Practice Address - City:BRANDYWINE
Practice Address - State:MD
Practice Address - Zip Code:20613-5948
Practice Address - Country:US
Practice Address - Phone:202-751-9481
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-06
Last Update Date:2024-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator