Provider Demographics
NPI:1386496099
Name:AJEWOLE, OLAKUNLE
Entity type:Individual
Prefix:
First Name:OLAKUNLE
Middle Name:
Last Name:AJEWOLE
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 1:1818 NEW YORK AVE NE STE 221
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20002-1851
Mailing Address - Country:US
Mailing Address - Phone:470-979-8069
Mailing Address - Fax:
Practice Address - Street 1:1818 NEW YORK AVE NE STE 221
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20002-1851
Practice Address - Country:US
Practice Address - Phone:470-979-8069
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-04
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator