Individual
DR. OLUFEMI EBUNOLU BALOGUN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1221 MERCANTILE LN, UPPER MARLBORO, MD 20774-5374
(301) 618-5500
Mailing address
2101 E JEFFERSON ST STE 6W, ROCKVILLE, MD 20852-4908
(301) 816-5853
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
0101262023
VA
207Q00000X
Family Medicine Physician
Primary
D83130
MD
207Q00000X
Family Medicine Physician
MD044945
DC
Other
Enumeration date
06/13/2011
Last updated
06/10/2021
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