Provider Demographics
NPI:1386995769
Name:AWOYINFA, OLUWAFEMI EDWIN
Entity type:Individual
Prefix:
First Name:OLUWAFEMI
Middle Name:EDWIN
Last Name:AWOYINFA
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 1:3602 55TH AVE APT 6
Mailing Address - Street 2:
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20784-1151
Mailing Address - Country:US
Mailing Address - Phone:202-304-4467
Mailing Address - Fax:
Practice Address - Street 1:3602 55TH AVE APT 6
Practice Address - Street 2:
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20784-1151
Practice Address - Country:US
Practice Address - Phone:202-304-4467
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-26
Last Update Date:2013-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD1386995769Medicaid