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Maryland Board of Physicians
Practitioner Profile Portal
This data was extracted on
10/8/2026
.
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Profile
License Number
:
C0004550
Adeola Patience Fagbohunka
License Type
:
Physician Assistant
License Status
:
Active
License Issued
:
08/24/2011
License Expiration:
06/30/2027
Licensure Pathway:
Traditional
Special License Category:
N/A
Education
N/A
Medical Assistance
Accept Medicaid?
N/A
Maryland Hospital Privilege Information
(as reported by licensee)
Luminis Health Doctors Community Medical Ctr, Inc
Umd Baltimore Washington Medical Center
Medstar Harbor Hospital
Medstar Montgomery Medical Center
Medstar Union Memorial Hospital
Medstar Franklin Square Medical Center
Medical Licenses Held in Other States
(as reported by licensee)
Licensee has not reported Medical Licenses Held in Other States information for the profile site.
Physician Assistant Notification of Collaboration Agreements
Agreement ID: 4222 | Submit Date: 05/08/2025
Practice Setting: Hospital
Facility: Medstar Saint Mary's Hospital
Address: 25500 Point Lookout Road
Leonardtown, MD 20650
Advanced Duties: No | Prescriptive Authority: Yes | Dispensing Authority: No
View Collaboration Agreement
Agreement ID: 5524 | Submit Date: 06/10/2025
Practice Setting: Hospital
Facility: Medstar Southern Maryland Hospital Center
Address: 7503 Surratts Road
Clinton, MD 20735
Advanced Duties: No | Prescriptive Authority: Yes | Dispensing Authority: No
View Collaboration Agreement
Active Supervisee - Delegation Agreement For Core Duties
D0063430
Ravitej Singh Khunkhun Status: Approved |
Approved Date:
11/30/2016 | Agreement No: 15343
Prescribe CDS: Yes | Non-CDS: Yes | Medical Devices: Yes
Dispense CDS: No | Dispense NCDS: No
D0058226
John Timothy Antoniades Status: Approved |
Approved Date:
12/20/2017 | Agreement No: 16554
Prescribe CDS: Yes | Non-CDS: Yes | Medical Devices: Yes
Dispense CDS: No | Dispense NCDS: No
D0083427
David Nathanael Lauver Status: Approved |
Approved Date:
08/11/2021 | Agreement No: 22496
Prescribe CDS: Yes | Non-CDS: Yes | Medical Devices: Yes
Dispense CDS: No | Dispense NCDS: No
D0068987
Shams Tabrez Quazi Status: Approved |
Approved Date:
01/18/2024 | Agreement No: 33442
Prescribe CDS: Yes | Non-CDS: Yes | Medical Devices: Yes
Dispense CDS: No | Dispense NCDS: No
Download all Maryland Disciplinary Actions
(not time-limited)
All Orders are downloaded in .pdf format.
None.
Summary of Known Disciplinary Actions by any state medical board
In Maryland:
No Known Disciplinary Actions by the Maryland Board of Physicians have been reported.
Other States:
No Known Disciplinary Actions by any other state medical board have been reported.
Pending Charges
All Charges are downloaded in .pdf format.
None.
Other Public Actions in the Practice of the Profession or Administrative Fines
(including Maryland)
No reported Other Public Actions in the Practice of the Profession or Administrative Fines (incl. Maryland) for this licensee.
Convictions for any crime involving moral turpitude
None reported by the courts.
Appendix
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Notice to Credential Verification Professionals