Individual
OLAIDE ISRAEL AYEGBUSI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
7650 PORT CAPITAL DR, JESSUP, MD 20794-6793
(410) 799-7770
Mailing address
929 MONTGOMERY ST APT B, LAUREL, MD 20707-3427
(240) 360-7941
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
26738
MD
Other
Enumeration date
08/22/2019
Last updated
08/22/2019
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