Provider Demographics
NPI:1033620398
Name:ARIGBAMU, SAMSON OLANREWAJU (CRNP)
Entity Type:Individual
Prefix:
First Name:SAMSON
Middle Name:OLANREWAJU
Last Name:ARIGBAMU
Suffix:
Gender:M
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4800 SETON DRIVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21215
Mailing Address - Country:US
Mailing Address - Phone:410-358-3410
Mailing Address - Fax:410-358-4938
Practice Address - Street 1:10451 MILL RUN CIR STE 730
Practice Address - Street 2:
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117-5669
Practice Address - Country:US
Practice Address - Phone:410-303-0057
Practice Address - Fax:410-358-4938
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-13
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR161520363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology