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NPI Code Detail

MEDICARE: MRS. ADETUTU OLUFUNMILAYO MARIOGHAE

MEDICARE:  MRS. ADETUTU OLUFUNMILAYO MARIOGHAE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LW0102XWomen's Health Nurse Practitioner0024176630VA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10024176630OTHERVACOMMONWEALTH OF VIRGINIA DEPARTMENT OF HEALTH PROFESSION

General Provider Information

NPI Number : 1326500976
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. ADETUTU OLUFUNMILAYO MARIOGHAE
Provider Business Mailing Address
First Line : 1101 WILSON BLVD FL 6
Second Line :
City : ARLINGTON
State : VA
Zip : 22209-2281
Country : US
Telephone Number : 888-731-8994
Fax Number :
Provider Business Practice Location Address
First Line : 1101 WILSON BLVD FL 6
Second Line :
City : ARLINGTON
State : VA
Zip : 22209-2281
Country : US
Telephone Number : 888-731-8994
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/03/2019
Last Update Date : 01/19/2026

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Directions to “ MRS. ADETUTU OLUFUNMILAYO MARIOGHAE ” Practice Location

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