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General NPI Number Information
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NPI Number | 1801666334
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Entity Type | Individual
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Provider Name | ADESOLA I OGUNDOLIE
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Gender | Female
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Dates
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Enumeration Date | 01/05/2024
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Last Update Date | 01/05/2024
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Provider Practice Location Address
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Address Line | 2512 24TH ST NE # E
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City | WASHINGTON
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State | DC
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Zip | 20018-2126
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Country | US
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Telephone | 202-832-8340
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Fax | 202-832-8340
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Provider Business Mailing Address
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Address Line | 19 HOBART CT
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City | RANDALLSTOWN
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State | MD
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Zip | 21133-2407
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Country | US
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Telephone | 862-600-7058
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN500003610
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License Number State | DC
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