Individual
DR. OLAKUNLE O ABISUGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
14139 POTOMAC MILLS ROAD, WOODBRIDGE, VA 22192-4644
(703) 490-8400
(703) 490-7635
Mailing address
2101 E JEFFERSON ST, KAISER PERMANENTE MEDICARE ENROLLMENT, ROCKVILLE, MD 20852-4908
(301) 816-2424
(301) 816-2424
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101058776
VA
207R00000X
Internal Medicine Physician
D0072743
MD
207R00000X
Internal Medicine Physician
MD039292
DC
Other
Enumeration date
12/04/2006
Last updated
02/04/2022
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