Provider Demographics
NPI:1891331716
Name:OGU, SHAMARIAH FINJAP
Entity Type:Individual
Prefix:
First Name:SHAMARIAH
Middle Name:FINJAP
Last Name:OGU
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 1:4203 55TH AVE
Mailing Address - Street 2:
Mailing Address - City:BLADENSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20710-1507
Mailing Address - Country:US
Mailing Address - Phone:202-492-6995
Mailing Address - Fax:
Practice Address - Street 1:4203 55TH AVE
Practice Address - Street 2:
Practice Address - City:BLADENSBURG
Practice Address - State:MD
Practice Address - Zip Code:20710-1507
Practice Address - Country:US
Practice Address - Phone:202-492-6995
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-26
Last Update Date:2019-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant