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Individual

PETER OLUSOLA IGE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
5411 OLD FREDERICK RD, BALTIMORE, MD 21229-2195
(410) 762-8945
Mailing address
12 ROZINA CT, OWINGS MILLS, MD 21117-1318
(410) 446-1294

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
R142898
MD

Other

Enumeration date
12/12/2019
Last updated
12/12/2019
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