Provider Demographics
NPI:1912678244
Name:OLUJOBI, BABATUNDE (CRNP)
Entity Type:Individual
Prefix:
First Name:BABATUNDE
Middle Name:
Last Name:OLUJOBI
Suffix:
Gender:M
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11405 VILLA CT
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20774-5702
Mailing Address - Country:US
Mailing Address - Phone:718-309-1190
Mailing Address - Fax:443-451-1716
Practice Address - Street 1:1020 SAINT PAUL ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21202-2606
Practice Address - Country:US
Practice Address - Phone:410-529-0348
Practice Address - Fax:443-451-1716
Is Sole Proprietor?:No
Enumeration Date:2021-09-27
Last Update Date:2021-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR202077363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health