Provider Demographics
NPI:1033582655
Name:UTHMAN, OGUNSEYE
Entity Type:Individual
Prefix:
First Name:OGUNSEYE
Middle Name:
Last Name:UTHMAN
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 1:5651 KENNEDY ST
Mailing Address - Street 2:APT. 205
Mailing Address - City:RIVERDALE
Mailing Address - State:MD
Mailing Address - Zip Code:20737-2749
Mailing Address - Country:US
Mailing Address - Phone:240-898-7938
Mailing Address - Fax:
Practice Address - Street 1:5651 KENNEDY ST
Practice Address - Street 2:APT. 205
Practice Address - City:RIVERDALE
Practice Address - State:MD
Practice Address - Zip Code:20737-2749
Practice Address - Country:US
Practice Address - Phone:240-898-7938
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-04
Last Update Date:2015-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCRN1027519163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse