Provider Demographics
NPI:1447492251
Name:AKINLOSOTU, RAYMOND OLUSEGUN (NP)
Entity type:Individual
Prefix:
First Name:RAYMOND
Middle Name:OLUSEGUN
Last Name:AKINLOSOTU
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:12308 MARKBY CT
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20774-5647
Mailing Address - Country:US
Mailing Address - Phone:301-404-5871
Mailing Address - Fax:240-206-9599
Practice Address - Street 1:9605 MEDICAL CENTER DR
Practice Address - Street 2:SUITE 170
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-6380
Practice Address - Country:US
Practice Address - Phone:301-251-4702
Practice Address - Fax:301-762-5711
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-26
Last Update Date:2015-03-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
DCRN60098363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health