Fredrick Olapade Abimbola-Peters
Individual provider Active NPI Home Health Aide · Laurel, MD
NPI 1609410083 · NPPES record last updated Oct 29, 2019
Key facts
- NPI
- 1609410083
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Home Health Aide 374U00000X
- License
- HHA14847 (DC)
- Practice address
- 11694 S Laurel Dr Apt 4B
Laurel, MD 20708-3039 - Phone
- (240) 264-0882
- NPI assigned
- Oct 29, 2019
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| HHA14847 | DC | MD | Home Health Aide |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Aide | 374U00000X | HHA14847 | DC | Yes |
Addresses
Primary practice location
11694 S Laurel Dr Apt 4B
Laurel, MD 20708-3039
Mailing address
11694 S Laurel Dr Apt 4B
Laurel, MD 20708-3039
Phone (240) 264-0882
Other providers in Laurel, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 29, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.