Individual
IFEDAYO ABIOLA-MATTHEW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
22 S GREENE ST, BALTIMORE, MD 21201-1544
(410) 328-9595
Mailing address
22 S GREENE ST, BALTIMORE, MD 21201-1544
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
R196652
MD
363LF0000X
Family Nurse Practitioner
R196652
MD
Other
Enumeration date
07/16/2021
Last updated
11/02/2021
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