Organization
BENJAMIN ADEWALE MD PC
Active
Parent organization
BENJAMIN A. ADEWALE MD PC
Other names
Riverside Mental Health LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
BENJAMIN A. ADEWALE MD PC
Authorized official
BENJAMIN ADYSON ADENWALE MD (MEDICAL DIRECTOR MD)
(703) 569-8028
Entity
Organization
Contact information
Practice address
7011 CALAMO ST, #105, SPRINGFIELD, VA 22150
(703) 569-8028
(703) 569-8085
Mailing address
PO BOX 8057, ALEXANDRIA, VA 22306-8057
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
—
—
2084P0800X
Psychiatry Physician
—
—
261QV0200X
VA Clinic/Center
0101054165
VA
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
07/15/2006
Last updated
01/17/2018
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