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General NPI Number Information
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NPI Number | 1275917577
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Entity Type | Individual
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Provider Name | CHRISTOPHER DUAKA OBIOGBOLU NP
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Gender | Male
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Dates
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Enumeration Date | 07/16/2015
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Last Update Date | 09/04/2015
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Provider Practice Location Address
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Address Line | 4310 HUNT PLACE, N.E
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City | WASHINGTON
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State | DC
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Zip | 20019
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Country | US
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Telephone | 202-388-4300
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Fax |
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Provider Business Mailing Address
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Address Line | 10511 CAMPUS WAY SOUTH
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City | UPPER MARLBORO
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State | MD
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Zip | 20774
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Country | US
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Telephone | 410-900-8888
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | RN1016225
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License Number State | DC
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | R181376
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License Number State | MD
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Taxonomy #3
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | R181376
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License Number State | MD
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