Provider Demographics
NPI:1689243354
Name:OBANYE, MURRAY IYKE
Entity Type:Individual
Prefix:
First Name:MURRAY
Middle Name:IYKE
Last Name:OBANYE
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 1:6615 REISTERSTOWN RD STE 302
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21215-2689
Mailing Address - Country:US
Mailing Address - Phone:410-383-4263
Mailing Address - Fax:410-580-2037
Practice Address - Street 1:6615 REISTERSTOWN RD STE 302
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21215-2689
Practice Address - Country:US
Practice Address - Phone:410-383-4263
Practice Address - Fax:410-580-2037
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-17
Last Update Date:2022-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR180800363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily