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General NPI Number Information
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NPI Number | 1649947938
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Entity Type | Individual
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Provider Name | TOKUNBO OBIDIRAN RN
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Gender | Male
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Dates
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Enumeration Date | 08/25/2021
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Last Update Date | 08/25/2021
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Provider Practice Location Address
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Address Line | 1949 4TH ST NE
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City | WASHINGTON
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State | DC
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Zip | 20002-1211
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Country | US
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Telephone | 202-462-7500
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Fax |
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Provider Business Mailing Address
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Address Line | 907 CYPRESS POINT CIR
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City | BOWIE
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State | MD
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Zip | 20721-2303
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Country | US
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Telephone |
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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 | 163WP0809X
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Taxonomy Name | Adult Psychiatric/Mental Health Registered Nurse
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License Number | RN1046692
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License Number State | DC
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