Provider Demographics
NPI:1477958429
Name:METRO XTRACARE P.C.
Entity Type:Organization
Organization Name:METRO XTRACARE P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BABAJIDE
Authorized Official - Middle Name:O
Authorized Official - Last Name:RUNSEWE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:443-272-7858
Mailing Address - Street 1:3608 MILFORD MILL RD
Mailing Address - Street 2:
Mailing Address - City:WINDSOR MILL
Mailing Address - State:MD
Mailing Address - Zip Code:21244-3328
Mailing Address - Country:US
Mailing Address - Phone:443-272-7858
Mailing Address - Fax:
Practice Address - Street 1:3608 MILFORD MILL RD
Practice Address - Street 2:
Practice Address - City:WINDSOR MILL
Practice Address - State:MD
Practice Address - Zip Code:21244-3328
Practice Address - Country:US
Practice Address - Phone:443-272-7858
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-31
Last Update Date:2023-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD15720816261QP2300X, 261QU0200X
261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care