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NPI Code Detail

MEDICARE: TAIWO BALOGUN

MEDICARE: TAIWO BALOGUN
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
1374U00000XHome Health Aide

General Provider Information

NPI Number : 1720934060
Entity Type Code : Individual
Provider Name (Legal Business Name) : TAIWO BALOGUN
Provider Business Mailing Address
First Line : 4408 CLAY ST NE
Second Line :
City : WASHINGTON
State : DC
Zip : 20019-4658
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4408 CLAY ST NE
Second Line :
City : WASHINGTON
State : DC
Zip : 20019-4658
Country : US
Telephone Number : 202-290-7448
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/09/2026
Last Update Date : 03/09/2026

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Directions to “ TAIWO BALOGUN ” Practice Location

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