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General NPI Number Information
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NPI Number | 1649368796
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Entity Type | Individual
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Provider Name | TEMITOPE OLUWAYEMISI GBOLAGUN RPH. PHARM.D
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Gender | Female
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Dates
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Enumeration Date | 10/11/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 9213 LAKESIDE BLVD
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City | OWINGS MILLS
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State | MD
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Zip | 21117-3859
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Country | US
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Telephone | 410-654-4441
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Fax | 410-654-4463
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Provider Business Mailing Address
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Address Line | 9476 FENS HOLW
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City | LAUREL
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State | MD
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Zip | 20723-5732
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Country | US
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Telephone | 301-604-5507
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Fax | 410-654-4441
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 16665
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License Number State | MD
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