Basic Information
Provider Information
NPI: 1225659089
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: AKANDE
FirstName: OLUWATOFEHINTI
MiddleName: OLUWALADEMI
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 35048 BUNKER HILL DR
Address2:  
City: FARMINGTON HILLS
State: MI
PostalCode: 483313238
CountryCode: US
TelephoneNumber: 2487977685
FaxNumber:  
Practice Location
Address1: 4201 ST. ANTOINE
Address2: ROOM 2E-UHC
City: DETROIT
State: MI
PostalCode: 48201
CountryCode: US
TelephoneNumber: 3135774342
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/04/2020
LastUpdateDate: 05/04/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 05/04/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
390200000X  Y Student, Health CareStudent in an Organized Health Care Education/Training Program 

No ID Information.


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