Provider Demographics
NPI:1700138898
Name:GIWA, OLUWAFEMI MOSES JR
Entity Type:Individual
Prefix:
First Name:OLUWAFEMI
Middle Name:MOSES
Last Name:GIWA
Suffix:JR
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 1:10003 LINDLEY CT
Mailing Address - Street 2:
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-2391
Mailing Address - Country:US
Mailing Address - Phone:443-447-1478
Mailing Address - Fax:
Practice Address - Street 1:10003 LINDLEY CT
Practice Address - Street 2:
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706
Practice Address - Country:US
Practice Address - Phone:443-447-1478
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-12
Last Update Date:2012-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171100000X
DCAHI103121376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide
No171100000XOther Service ProvidersAcupuncturist