Provider Demographics
NPI:1083087357
Name:SALAMI, OLUBUNMI
Entity Type:Individual
Prefix:
First Name:OLUBUNMI
Middle Name:
Last Name:SALAMI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4920 NIAGARA RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:COLLEGE PARK
Mailing Address - State:MD
Mailing Address - Zip Code:20740-1110
Mailing Address - Country:US
Mailing Address - Phone:301-637-7078
Mailing Address - Fax:301-345-9200
Practice Address - Street 1:4920 NIAGARA RD
Practice Address - Street 2:SUITE 102
Practice Address - City:COLLEGE PARK
Practice Address - State:MD
Practice Address - Zip Code:20740-1110
Practice Address - Country:US
Practice Address - Phone:301-637-7078
Practice Address - Fax:301-345-9200
Is Sole Proprietor?:No
Enumeration Date:2015-11-08
Last Update Date:2015-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR208317163W00000X, 163WA2000X, 163WC0200X, 163WH0200X
MDR3823163WE0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health
No163W00000XNursing Service ProvidersRegistered Nurse
No163WA2000XNursing Service ProvidersRegistered NurseAdministrator
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine
No163WE0003XNursing Service ProvidersRegistered NurseEmergency