Healthcare Provider Details
I. General information
NPI: 1649511973
Provider Name (Legal Business Name): NESBURG INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/12/2013
Last Update Date: 06/20/2026
Certification Date: 06/20/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3350 WILKENS AVENUE SUITE 302
BALTIMORE MD
21229
US
IV. Provider business mailing address
3350 WILKENS AVENUE SUITE 302
BALTIMORE MD
21229
US
V. Phone/Fax
- Phone: 443-722-0954
- Fax:
- Phone: 410-800-4572
- Fax: 410-286-1923
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ABIOLA
OBATUASE
Title or Position: OWNER
Credential: NP
Phone: 443-722-0954