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NPI Code Detail

MEDICARE: OLUWATOYIN O IFESANYA PHARM.D.

MEDICARE: OLUWATOYIN O IFESANYA PHARM.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist22641MD

General Provider Information

NPI Number : 1043613631
Entity Type Code : Individual
Provider Name (Legal Business Name) : OLUWATOYIN O IFESANYA PHARM.D.
Provider Business Mailing Address
First Line : 8501 FORT SMALLWOOD RD
Second Line :
City : PASADENA
State : MD
Zip : 21122-2607
Country : US
Telephone Number : 410-437-1149
Fax Number :
Provider Business Practice Location Address
First Line : 8501 FORT SMALLWOOD RD
Second Line :
City : PASADENA
State : MD
Zip : 21122-2607
Country : US
Telephone Number : 410-437-1149
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/26/2014
Last Update Date : 09/26/2014

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