Healthcare Provider Details

I. General information

NPI: 1154796183
Provider Name (Legal Business Name): OLUBUNMI HANNAH OWOJUYIGBE PHARMACIST
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/02/2015
Last Update Date: 12/02/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2124 E MONUMENT ST
BALTIMORE MD
21205-2334
US

IV. Provider business mailing address

2124 E MONUMENT ST
BALTIMORE MD
21205-2334
US

V. Phone/Fax

Practice location:
  • Phone: 410-617-8742
  • Fax:
Mailing address:
  • Phone: 410-617-8742
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number17901
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: