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General NPI Number Information
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NPI Number | 1710643564
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Entity Type | Individual
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Provider Name | ISHAQ OLAYINKA GIWA DNP
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Gender | Male
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Dates
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Enumeration Date | 11/15/2021
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Last Update Date | 07/24/2023
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Provider Practice Location Address
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Address Line | 1910 N BROADWAY STE 101
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City | BALTIMORE
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State | MD
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Zip | 21213-1444
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Country | US
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Telephone | 410-366-1893
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Fax |
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Provider Business Mailing Address
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Address Line | 8205 REECEWOOD DR
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City | SEVERN
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State | MD
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Zip | 21144-3049
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Country | US
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Telephone | 410-499-3997
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | R199309
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 199309
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License Number State | MD
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