Provider Demographics
NPI:1295504348
Name:SANUSI, OLAJUMOKE
Entity type:Individual
Prefix:MRS
First Name:OLAJUMOKE
Middle Name:
Last Name:SANUSI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15609 BIRCH RUN TER
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20707-3583
Mailing Address - Country:US
Mailing Address - Phone:240-810-4106
Mailing Address - Fax:
Practice Address - Street 1:1338 N CAPITOL ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20002-3396
Practice Address - Country:US
Practice Address - Phone:202-745-0073
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-29
Last Update Date:2023-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator