Provider Demographics
NPI:1710643564
Name:GIWA, ISHAQ OLAYINKA (DNP)
Entity Type:Individual
Prefix:DR
First Name:ISHAQ
Middle Name:OLAYINKA
Last Name:GIWA
Suffix:
Gender:M
Credentials:DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8205 REECEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:SEVERN
Mailing Address - State:MD
Mailing Address - Zip Code:21144-3049
Mailing Address - Country:US
Mailing Address - Phone:410-499-3997
Mailing Address - Fax:
Practice Address - Street 1:1910 N BROADWAY STE 101
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21213-1444
Practice Address - Country:US
Practice Address - Phone:410-366-1893
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-15
Last Update Date:2023-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR199309363LP0808X
MD199309363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health