Provider Demographics
NPI:1417679036
Name:OGUNBIYI, OLADAPO
Entity Type:Individual
Prefix:
First Name:OLADAPO
Middle Name:
Last Name:OGUNBIYI
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 1:8519 GREENBELT RD APT 203
Mailing Address - Street 2:
Mailing Address - City:GREENBELT
Mailing Address - State:MD
Mailing Address - Zip Code:20770-2315
Mailing Address - Country:US
Mailing Address - Phone:240-486-5024
Mailing Address - Fax:
Practice Address - Street 1:8519 GREENBELT RD APT 203
Practice Address - Street 2:
Practice Address - City:GREENBELT
Practice Address - State:MD
Practice Address - Zip Code:20770-2315
Practice Address - Country:US
Practice Address - Phone:240-486-5024
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-12
Last Update Date:2022-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA200001872374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide