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Individual

INI BALOGUN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
4305 NORTHVIEW DR, BOWIE, MD 20716-2600
(240) 473-9999
Mailing address
10813 RHODENDA PL, UPPER MARLBORO, MD 20772-4824
(571) 201-9970

Taxonomy

Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
R210483
MD

Other

Enumeration date
11/03/2025
Last updated
11/03/2025
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