Provider Demographics
NPI:1821318080
Name:OGUNDIJO, OLUWATOYIN M (RPH)
Entity Type:Individual
Prefix:MRS
First Name:OLUWATOYIN
Middle Name:M
Last Name:OGUNDIJO
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11501 MYER RD
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20721-2528
Mailing Address - Country:US
Mailing Address - Phone:240-463-9054
Mailing Address - Fax:
Practice Address - Street 1:3804 LIBERTY HEIGHTS AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21215-7119
Practice Address - Country:US
Practice Address - Phone:410-356-5151
Practice Address - Fax:410-367-2718
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-09
Last Update Date:2010-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD13082183500000X
DCPH3014183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist