Provider Demographics
NPI:1548365927
Name:AKOTO, RICHARD O (MD PA)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:O
Last Name:AKOTO
Suffix:
Gender:M
Credentials:MD PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7610 CARROLL AVE STE 450
Mailing Address - Street 2:
Mailing Address - City:TAKOMA PARK
Mailing Address - State:MD
Mailing Address - Zip Code:20912-6324
Mailing Address - Country:US
Mailing Address - Phone:301-681-9500
Mailing Address - Fax:301-681-6570
Practice Address - Street 1:7610 CARROLL AVE STE 450
Practice Address - Street 2:
Practice Address - City:TAKOMA PARK
Practice Address - State:MD
Practice Address - Zip Code:20912-6324
Practice Address - Country:US
Practice Address - Phone:301-681-9500
Practice Address - Fax:301-681-6570
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-13
Last Update Date:2022-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0058683207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD43861D800Medicaid
DCG01391R03Medicare ID - Type Unspecified
MDH67066Medicare UPIN
MD753M302FMedicare ID - Type Unspecified