| Mary Ogunsanya | |
|
12150 Annapolis Rd Ste 208 Glenn Dale MD 20769-9183 | |
| (301) 218-0398 | |
| (301) 218-0040 |
| Full Name | Mary Ogunsanya |
|---|---|
| Speciality | Clinic/Center |
| Location | 12150 Annapolis Rd, Glenn Dale, Maryland |
| Authorized Official Name and Position | Mary Ogunsanya (OWNER/PROVIDER) |
| Authorized Official Contact | 3012180398 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mary Ogunsanya P.o.box 2132 Bowie MD 20718-2132 Ph: (301) 218-0398 | Mary Ogunsanya 12150 Annapolis Rd Ste 208 Glenn Dale MD 20769-9183 Ph: (301) 218-0398 |
| NPI Number | 1558635235 |
|---|---|
| Provider Enumeration Date | 02/28/2012 |
| Last Update Date | 02/28/2012 |
| Medicare PECOS PAC ID | 2062821960 |
|---|---|
| Medicare Enrollment ID | O20210505002061 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558635235 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | D005630 (Maryland) | Primary |
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