Provider Demographics
NPI:1386475184
Name:AKINWALE, KUNLE EMMANUEL
Entity type:Individual
Prefix:
First Name:KUNLE
Middle Name:EMMANUEL
Last Name:AKINWALE
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 1:10781 KITCHENER CT
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20721-1854
Mailing Address - Country:US
Mailing Address - Phone:240-898-8142
Mailing Address - Fax:
Practice Address - Street 1:2918 MINNESOTA AVE SE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20019-1127
Practice Address - Country:US
Practice Address - Phone:202-839-5310
Practice Address - Fax:202-810-9189
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-12
Last Update Date:2024-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator