Healthcare Provider Details

I. General information

NPI: 1992336465
Provider Name (Legal Business Name): BOLANLE KEMI ROTIMI-OHAI CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/03/2020
Last Update Date: 02/03/2020
Certification Date: 02/03/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

SINAI HOSPITAL OF BALTIMORE 2401 W BELVEDERE AVE
BALTIMORE MD
21215
US

IV. Provider business mailing address

9394 3RD ST N
LAUREL MD
20723-1921
US

V. Phone/Fax

Practice location:
  • Phone: 301-675-8407
  • Fax:
Mailing address:
  • Phone: 301-675-8407
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberR182993
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: