Provider Demographics
NPI:1497095202
Name:OGUNREMI, CHRISTOPHER ADEOYE
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:ADEOYE
Last Name:OGUNREMI
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 1:108 AUTOMOTIVE BLVD
Mailing Address - Street 2:
Mailing Address - City:ELKTON
Mailing Address - State:MD
Mailing Address - Zip Code:21921-6374
Mailing Address - Country:US
Mailing Address - Phone:302-757-4765
Mailing Address - Fax:
Practice Address - Street 1:108 AUTOMOTIVE BLVD
Practice Address - Street 2:
Practice Address - City:ELKTON
Practice Address - State:MD
Practice Address - Zip Code:21921-6374
Practice Address - Country:US
Practice Address - Phone:302-757-4765
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-15
Last Update Date:2013-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide