Provider Demographics
NPI:1346576881
Name:ODEBUNMI, OLUWASEUN (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:OLUWASEUN
Middle Name:
Last Name:ODEBUNMI
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7975 HEATHER MIST DR
Mailing Address - Street 2:
Mailing Address - City:SEVERN
Mailing Address - State:MD
Mailing Address - Zip Code:21144-1079
Mailing Address - Country:US
Mailing Address - Phone:240-893-4240
Mailing Address - Fax:301-543-8456
Practice Address - Street 1:7975 HEATHER MIST DR
Practice Address - Street 2:
Practice Address - City:SEVERN
Practice Address - State:MD
Practice Address - Zip Code:21144-1079
Practice Address - Country:US
Practice Address - Phone:240-893-4240
Practice Address - Fax:301-543-8456
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-18
Last Update Date:2009-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD184981835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist