Timothy Olukanni, | |
900 23rd St Nw, Washington, DC 20037-2342 | |
(202) 715-4000 | |
Not Available |
Full Name | Timothy Olukanni |
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Gender | Male |
Speciality | Anesthesiologist Assistant |
Location | 900 23rd St Nw, Washington, District Of Columbia |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1033801832 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
367H00000X | Anesthesiologist Assistant | 789789819 (Virginia) | Secondary |
367H00000X | Anesthesiologist Assistant | AA2000047 (District Of Columbia) | Primary |
Entity Name | Medical Faculty Associates, Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1417990581 PECOS PAC ID: 4082528898 Enrollment ID: O20031117000341 |
Mailing Address | Practice Location Address |
---|---|
Timothy Olukanni, 1600 S Joyce St Apt 1731, Arlington, VA 22202-5135 Ph: (757) 701-9850 | Timothy Olukanni, 900 23rd St Nw, Washington, DC 20037-2342 Ph: (202) 715-4000 |
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