Healthcare Provider Details

I. General information

NPI: 1134350911
Provider Name (Legal Business Name): TAIWO OLUBANKE LAWOYIN MD, MPH, CPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2009
Last Update Date: 08/06/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 ARMORY PL SUITE 3M
BALTIMORE MD
21201-4603
US

IV. Provider business mailing address

9322 PIRATES CV
COLUMBIA MD
21046-1623
US

V. Phone/Fax

Practice location:
  • Phone: 410-225-8615
  • Fax:
Mailing address:
  • Phone: 443-535-2077
  • Fax: 410-381-2994

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License NumberD0030085
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: