Provider Demographics
NPI:1427080621
Name:ERINLE, AKINWANDE OLUMIDE (MD)
Entity type:Individual
Prefix:DR
First Name:AKINWANDE
Middle Name:OLUMIDE
Last Name:ERINLE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 25185
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37422-5185
Mailing Address - Country:US
Mailing Address - Phone:423-499-6400
Mailing Address - Fax:423-899-3438
Practice Address - Street 1:103 JORDAN DR
Practice Address - Street 2:SUITE 3
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-6715
Practice Address - Country:US
Practice Address - Phone:423-499-6400
Practice Address - Fax:423-899-3438
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD025188208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA525731Medicaid
TN3082302Medicaid
GA525731Medicaid