Healthcare Provider Details

I. General information

NPI: 1750256558
Provider Name (Legal Business Name): ACZOBI MEDICAL NUCLEAR MEDICINE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/09/2025
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5885 ALLENTOWN RD STE B
SUITLAND MD
20746-4570
US

IV. Provider business mailing address

5885 ALLENTOWN RD STE B
SUITLAND MD
20746-4570
US

V. Phone/Fax

Practice location:
  • Phone: 240-505-2127
  • Fax:
Mailing address:
  • Phone: 240-505-2127
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: AFOMA P OBIOGBOLU
Title or Position: OWNER
Credential: PMHNP, RN
Phone: 240-505-2127