Provider Demographics
NPI:1588359111
Name:DAWODU, RISIKAT OLUWAKEMI (NP)
Entity type:Individual
Prefix:MS
First Name:RISIKAT
Middle Name:OLUWAKEMI
Last Name:DAWODU
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MS
Other - First Name:RISIKAT
Other - Middle Name:OLUWAKEMI
Other - Last Name:DAWODU
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:NP
Mailing Address - Street 1:15605 TIBBERTON TER
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20774-9092
Mailing Address - Country:US
Mailing Address - Phone:144-396-8585
Mailing Address - Fax:
Practice Address - Street 1:15605 TIBBERTON TER
Practice Address - Street 2:
Practice Address - City:UPPER MARLBORO
Practice Address - State:MD
Practice Address - Zip Code:20774-9092
Practice Address - Country:US
Practice Address - Phone:144-396-8585
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-10
Last Update Date:2023-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR205998363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner