Basic Information
| Provider Information | |||||||||
| NPI: | 1174943641 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | ANWOJU | ||||||||
| FirstName: | OMOBOLANLE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7839 RIVERDALE RD APT 302 | ||||||||
| Address2: | 7839 RIVERDALE ROAD APT 302 | ||||||||
| City: | NEW CARROLLTON | ||||||||
| State: | MD | ||||||||
| PostalCode: | 207844021 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2404929903 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2512 24TH ST NE | ||||||||
| Address2: | 2512 24TH STREET | ||||||||
| City: | WASHINGTON | ||||||||
| State: | DC | ||||||||
| PostalCode: | 200182126 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2028328340 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/23/2014 | ||||||||
| LastUpdateDate: | 04/23/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 374U00000X | DC | Y | Nursing Service Related Providers | Home Health Aide |
No ID Information.