Provider Demographics
NPI:1396264750
Name:AKINTONDE, OLUWABUNMI D
Entity type:Individual
Prefix:
First Name:OLUWABUNMI
Middle Name:D
Last Name:AKINTONDE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13927 CASTLE BLVD APT 41
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20904-4953
Mailing Address - Country:US
Mailing Address - Phone:301-325-0917
Mailing Address - Fax:
Practice Address - Street 1:4370 MONTGOMERY RD
Practice Address - Street 2:
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21043-6006
Practice Address - Country:US
Practice Address - Phone:301-325-0917
Practice Address - Fax:301-325-0917
Is Sole Proprietor?:No
Enumeration Date:2017-09-15
Last Update Date:2017-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD25280183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist