Healthcare Provider Details

I. General information

NPI: 1184374480
Provider Name (Legal Business Name): PHILIP OREOLUWA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2022
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10440 LITTLE PATUXENT PKWY STE 300
COLUMBIA MD
21044-3648
US

IV. Provider business mailing address

10440 LITTLE PATUXENT PKWY STE 300
COLUMBIA MD
21044-3648
US

V. Phone/Fax

Practice location:
  • Phone: 325-899-2588
  • Fax:
Mailing address:
  • Phone: 325-899-2588
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberW1207
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number25MA12682200
License Number StateNJ
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD600005450
License Number StateDC
# 5
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberA206230
License Number StateCA
# 6
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberD0105700
License Number StateMD
# 7
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberME179942
License Number StateFL
# 8
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD490709
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: