Lanre Tajudeen Akinkunmi, M.D
Individual provider Active NPI Family Medicine Physician · Elkton, MD
NPI 1255413969 · NPPES record last updated Sep 27, 2010
Key facts
- NPI
- 1255413969
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- MD429647 (PA)
- Practice address
- 111 W High St
Suite 314
Elkton, MD 21921-5529 - Phone
- (410) 398-4679
- NPI assigned
- Oct 20, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MD
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20101202000713 | MD | Practitioner - Family Practice | 1052319100 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD429647 | PA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Christiana Care Quality Partners | Current |
Accepting new patients | |
| Union Hospital of Cecil County | Family Medicine | Current |
Accepting new patients |
| Union Hospital of Cecil County | Current |
Accepting new patients |
Locations
123 Singerly Ave
Elkton, MD 21921
Phone (410) 392-2686
210 Chesapeake Blvd
Elkton, MD 21921
310 E Pulaski Hwy
Elkton, MD 21921
Phone (443) 485-6213
106 Bow St
Elkton, MD 21921
Phone (410) 298-2000
111 W High St
Ste 314
Elkton, MD 21921
Phone (410) 398-4510
101 North East Plz
North East, MD 21901
Phone (410) 543-2020
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | MD429647 | PA | Yes |
Addresses
Primary practice location
111 W High St
Suite 314
Elkton, MD 21921-5529
Mailing address
111 W High St
Suite 314
Elkton, MD 21921-5529
Phone (410) 398-4679
Other providers in Elkton, MD
- Mohammad Basit Afzal
- Ahmed Farghal Ahmed
- Ishaq Ahmed
- Mohamed Ahmed
- Akena Counseling & Wellness, LLC
- Motunde Gbeminiyi Alade
- Shirley Alexander
- Alliance Healthcare Services Inc
- Alliance Healthcare Services Inc
- Alpha Dental Center
All providers in Elkton, MD · Family Medicine Physician in Maryland
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 27, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.