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General NPI Number Information
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NPI Number | 1710775655
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Entity Type | Individual
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Provider Name | AHMED OLAITAN ALEBIOSU
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Gender | Male
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Dates
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Enumeration Date | 04/29/2025
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Last Update Date | 12/26/2025
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Provider Practice Location Address
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Address Line | 5354 BROOK WAY APT 3
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City | COLUMBIA
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State | MD
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Zip | 21044-1638
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Country | US
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Telephone | 720-990-7570
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Fax |
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Provider Business Mailing Address
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Address Line | 11116 MEDICAL CAMPUS RD
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City | HAGERSTOWN
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State | MD
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Zip | 21742-6710
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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 | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | AC008162
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 1672282
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License Number State | CO
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