Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208D00000X | General Practice Physician | C1-0008405 | DE |
NPI | 1003005661 |
---|---|
Provider Name | Dr. Adefolaju Oketokun |
First Address | Washington, DC 20090-1280 |
Second Address | Washington, DC 20006-1631 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/10/2007 |
Last Update Date | 09/06/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
040597500 | (05) | DC |