Provider Demographics
NPI:1235945767
Name:EDGAL, AYOKUNLE EMMANUEL
Entity type:Individual
Prefix:
First Name:AYOKUNLE
Middle Name:EMMANUEL
Last Name:EDGAL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9301 OWINGS CHOICE CT
Mailing Address - Street 2:
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-6345
Mailing Address - Country:US
Mailing Address - Phone:202-931-2229
Mailing Address - Fax:
Practice Address - Street 1:9301 OWINGS CHOICE CT
Practice Address - Street 2:
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117-6345
Practice Address - Country:US
Practice Address - Phone:202-931-2229
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-09
Last Update Date:2024-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide