Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | D73472 | MD |
N | 208000000X | Pediatrician | MD041615 | DC |
N | 208000000X | Pediatrician | MT198090 | PA |
Y | 2080N0001X | Neonatal-Perinatal Doctor | 73472 | MD |
NPI | 1063733020 |
---|---|
Provider Name | Temitope O Akinmboni |
First Address | Baltimore, MD 21264-2063 |
Second Address | Cheverly, MD 20785-1189 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/06/2010 |
Last Update Date | 18/02/2020 |