Provider Demographics
NPI:1700104882
Name:BALOGUN, MARCUS AKINOLA III (MD)
Entity Type:Individual
Prefix:DR
First Name:MARCUS
Middle Name:AKINOLA
Last Name:BALOGUN
Suffix:III
Gender:M
Credentials:MD
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Mailing Address - Street 1:1835 UNIVERSITY BLVD E
Mailing Address - Street 2:SUITE 224
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20783-4600
Mailing Address - Country:US
Mailing Address - Phone:301-434-3111
Mailing Address - Fax:301-434-1223
Practice Address - Street 1:1835 UNIVERSITY BLVD. E
Practice Address - Street 2:SUITE 224
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20783-4600
Practice Address - Country:US
Practice Address - Phone:301-434-3111
Practice Address - Fax:301-434-1223
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-13
Last Update Date:2023-11-15
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Provider Licenses
StateLicense IDTaxonomies
DCMD16435207P00000X
VA0101037847207P00000X
MDD0036000207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine