Healthcare Provider Details
I. General information
NPI: 1578770871
Provider Name (Legal Business Name): TAOFEEK KUNLE OWONIKOKO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 05/17/2007
Last Update Date: 04/23/2026
Certification Date: 04/23/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
22 S GREENE ST
BALTIMORE MD
21201-1544
US
IV. Provider business mailing address
250 W PRATT ST STE 900
BALTIMORE MD
21201-6808
US
V. Phone/Fax
- Phone: 410-328-7904
- Fax:
- Phone: 410-328-5795
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RH0003X |
| Taxonomy | Hematology & Oncology Physician |
| License Number | MD427553 |
| License Number State | PA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RH0003X |
| Taxonomy | Hematology & Oncology Physician |
| License Number | D0099080 |
| License Number State | MD |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: