Provider Demographics
NPI:1275674111
Name:OGUNSOLA, HADDIJATOU SECKA (MD)
Entity Type:Individual
Prefix:DR
First Name:HADDIJATOU
Middle Name:SECKA
Last Name:OGUNSOLA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8055 RITCHIE HWY
Mailing Address - Street 2:SUITE 101
Mailing Address - City:PASADENA
Mailing Address - State:MD
Mailing Address - Zip Code:21122-1067
Mailing Address - Country:US
Mailing Address - Phone:443-825-4050
Mailing Address - Fax:443-825-4051
Practice Address - Street 1:8055 RITCHIE HWY
Practice Address - Street 2:SUITE 101
Practice Address - City:PASADENA
Practice Address - State:MD
Practice Address - Zip Code:21122-1067
Practice Address - Country:US
Practice Address - Phone:443-825-4050
Practice Address - Fax:443-825-4051
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-12
Last Update Date:2014-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0065596207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDAQ37-0001OtherCAREFIRST
MD134618YR86OtherMEDICARE GROUP MEMBER PTAN
DCAQ37-0001OtherCAREFIRST