Individual
ADEBUKOLA FASORO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
866 YUMA ST SE, WASHINGTON, DC 20032-3972
(240) 708-3148
Mailing address
11212 POMPEY DR, UPPER MARLBORO, MD 20772-4875
(240) 708-3148
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
06/15/2012
Last updated
01/30/2024
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