Provider Demographics
NPI:1174094759
Name:LAWAL, YINKA
Entity type:Individual
Prefix:
First Name:YINKA
Middle Name:
Last Name:LAWAL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13355 CASTLEWELLAN DR
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:23836-2904
Mailing Address - Country:US
Mailing Address - Phone:804-720-5164
Mailing Address - Fax:
Practice Address - Street 1:13355 CASTLEWELLAN DR
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:VA
Practice Address - Zip Code:23836-2904
Practice Address - Country:US
Practice Address - Phone:804-720-5164
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-07
Last Update Date:2024-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor