Healthcare Provider Details

I. General information

NPI: 1609770841
Provider Name (Legal Business Name): OYEBISI OGUNLEYE NCARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2026
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3204 CEDAR WAY
UPPER MARLBORO MD
20774-3534
US

IV. Provider business mailing address

3204 CEDAR WAY
UPPER MARLBORO MD
20774-3534
US

V. Phone/Fax

Practice location:
  • Phone: 227-206-7988
  • Fax:
Mailing address:
  • Phone: 227-206-7988
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: OYEBISI OYEFUNMIKE OGUNLEYE
Title or Position: MANAGER
Credential: PMHNP
Phone: 227-206-7988