Provider Demographics
NPI:1659058030
Name:SOLARIS GROUP
Entity Type:Organization
Organization Name:SOLARIS GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OWNER
Authorized Official - Prefix:
Authorized Official - First Name:OLASUNKANMI
Authorized Official - Middle Name:
Authorized Official - Last Name:ASABI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-643-2612
Mailing Address - Street 1:9241 OLD SCAGGSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20723-1729
Mailing Address - Country:US
Mailing Address - Phone:240-643-2616
Mailing Address - Fax:
Practice Address - Street 1:3219A CORPORATE CT
Practice Address - Street 2:
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21042-2247
Practice Address - Country:US
Practice Address - Phone:240-643-2612
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-28
Last Update Date:2023-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty