Peter Olusola Ige
Nurse Practitioner, Psych/Mental Health in Baltimore, MD. Individual provider (NPI-1).
NPI number1164060943
StatusActive
Last updated in NPPESDec 12, 2019
Details
- NPI
- 1164060943
- Entity type
- Individual (NPI-1)
- Name
- Peter Olusola Ige
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Dec 12, 2019
- Certification date
- Dec 12, 2019
- Last updated
- Dec 12, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LP0808X | Nurse Practitioner, Psych/Mental Health | R142898 | MD | Yes |
Practice location
5411 Old Frederick RdBaltimore, MD 21229-2195
Phone 410-762-8945
Mailing address
12 Rozina CtOwings Mills, MD 21117-1318
Phone 410-446-1294
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