OLUFEMI OTUBANJO (NPI# 1336450220) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336450220 |
| Entity Type | Individual |
| Full Name | OLUFEMI OTUBANJO |
| Credential | PA-C |
| Practice Address |
6480 Old Waterloo Rd Elkridge MD 21075-6508 |
| Practice Telephone | 4107990291 |
| Mailing Telephone | 2023404399 |
| Enumeration Date | 2010-06-25 |
| Last Update Date | 2020-05-19 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | C004195 | MD | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AM0700X |
Physician Assistant Specialization: Medical |
C0004195 | MD | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 300 E Madison St, Baltimore, MD 212024260 | 4102094493 |
| Street Address |
6480 OLD WATERLOO RD |
| City | ELKRIDGE |
| State | MD |
| Zip Code | 21075-6508 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457455305 | Maryland Cvs Pharmacy, L.L.C. | Pharmacy | 6480 Old Waterloo Rd, Elkridge, MD 21075-6508 | 2006-09-12 |
| 1164036216 | Fabrice Djoukam | Pharmacist | 6480 Old Waterloo Rd, Elkridge, MD 21075-6508 | 2020-09-05 |
| 1295373744 | Komal Patel | Family Medicine | 6480 Old Waterloo Rd, Elkridge, MD 21075-6508 | 2019-12-16 |
| 1902455579 | Agil K Jose | Pharmacist | 6480 Old Waterloo Rd, Elkridge, MD 21075-6508 | 2019-09-06 |
| 1649787011 | Vivian V Tan | Nurse Practitioner | 6480 Old Waterloo Rd, Elkridge, MD 21075 | 2018-01-05 |
| 1851835078 | Hoang-anh Tran | Pharmacist | 6480 Old Waterloo Rd, Elkridge, MD 21075-6508 | 2016-12-06 |
| 1841667698 | Stephanie Ann Jurkovic | Pharmacist | 6480 Old Waterloo Rd, Elkridge, MD 21075-6508 | 2015-08-27 |
| 1376952192 | Elise Bogard | Pharmacist | 6480 Old Waterloo Rd, Elkridge, MD 21075 | 2014-08-06 |
| 1104234624 | Mary Casciano | Pharmacist | 6480 Old Waterloo Rd, Elkridge, MD 21075-6508 | 2014-07-28 |
| 1134452733 | Traci Jean Hammel | Nurse Practitioner | 6480 Old Waterloo Rd, Elkridge, MD 21075-6508 | 2009-09-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174043640 | Howard County Health Department | Clinic/Center | 6925 Old Waterloo Road, Hchd Deep Run Elementary School-based Wellness Center, Elkridge, MD 21075 | 2017-06-26 |
| 1023485539 | Cvs | Clinic/Center | 6480 Old Waterloo Road, Elkridge, MD 21075 | 2015-09-01 |
| 1063762417 | Mid-atlantic Allergy & Asthma | Clinic/Center | 8182 Lark Brown Road, Elkridge, MD 21075 | 2012-09-13 |
| 1447522925 | Alberta Osei Agyeman | Social Worker | 7274 Elkridge Crossing Way, Elkridge, MD 21075 | 2012-01-31 |
| 1588970552 | Mira M Patel | Pharmacist | 7270 Montgomery Road, Rite Aid Pharmacy, Elkridge, MD 21075 | 2010-08-27 |
| 1710298112 | Emily Jeanne Marti | Nurse Practitioner | 6095 Marshalee Drive, Elkridge, MD 21075 | 2010-06-30 |
| 1538352612 | Costco Wholesale Corp | Pharmacy | 6675 Marie Curie Dr, Elkridge, MD 21075 | 2007-08-22 |
| 1225250707 | Orthosport Physical Therapy of Md | Clinic/Center | 8174 Lark Brown Road, Suite 101, Elkridge, MD 21075 | 2007-05-03 |
| 1164643086 | Linda M. Jones-laper | Dentist | 6865 Deerpath Rd Suite 100, Elkridge, MD 21075 | 2007-05-01 |
| 1487756813 | Robert E Skillman Jr. | Dentist | 5921 Old Washington Rd, Elkridge, MD 21075 | 2006-09-05 |
| Find all providers in zip 21075 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255712352 | Daniel Metz | Physician Assistant | 7472 Cedar Grove Ln, Elkridge, MD 21075-7916 | 2015-06-15 |
| 1750784781 | Lindsey Morgan Evans | Physician Assistant | 6020 Meadowridge Center Dr, Suite F, Elkridge, MD 21075-6528 | 2014-10-05 |
| 1356619480 | Nicole Elizabeth Dipeppe | Physician Assistant | 6518 Meadowridge Rd, Ste 106, Elkridge, MD 21075-6403 | 2011-12-04 |
| 1801051453 | Janet Angelique Browne-avery | Physician Assistant | 6095 Marshalee Dr, Ste 100, Elkridge, MD 21075-6053 | 2008-07-23 |
| 1144405382 | Brian Joseph Brooke | Physician Assistant | 7377 Washington Blvd, Suite 101, Elkridge, MD 21075-6360 | 2008-01-07 |
| 1457401473 | Julia Ortega Mceachern | Physician Assistant | 6085 Marshalee Dr, Suite 100, Elkridge, MD 21075-6023 | 2007-01-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427659325 | Stephanie Liss | Physician Assistant | 1003 Willowleaf Way, Potomac, MD 20854-2937 | 2020-11-05 |
| 1306447495 | Naftali Zapinsky | Physician Assistant | 3507 Labyrinth Rd, Baltimore, MD 21215-1731 | 2020-11-04 |
| 1306447768 | Elizabeth Kolbe Schneider | Physician Assistant | 2205 Deadora Dr, Bel Air, MD 21015-8521 | 2020-11-03 |
| 1982204160 | Bich-hanh Le | Physician Assistant | 16328 Decker Pl, Derwood, MD 20855-2181 | 2020-10-28 |
| 1972102416 | Francesca Mertan | Physician Assistant | 829 Concorde Cir Apt 4402, Linthicum Heights, MD 21090-1780 | 2020-10-24 |
| 1235738683 | Ester Dahee Kim | Physician Assistant | 2400 W Belvedere Ave, Baltimore, MD 21215-5216 | 2020-10-17 |
| 1245838804 | Erin Washington | Physician Assistant | 2708 Tallowtree Rd, Woodstock, MD 21163-1462 | 2020-10-15 |
| 1669070991 | Niklavs Peteris Eglitis | Physician Assistant | 905 Paulsboro Dr, Rockville, MD 20850-3027 | 2020-10-09 |
| 1922605583 | Kurt William Moulton | Physician Assistant | Health Center At Ward and West 8000 York Rd, Towson, MD 21252-0001 | 2020-10-07 |
| 1215541404 | Aaron Mccauley | Physician Assistant | 3 Dunhaven Pl Apt 2d, Nottingham, MD 21236-3161 | 2020-09-03 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.