Individual
OPANIN BA FOSU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNP
Contact information
Practice address
6994 MERLE CT, NEW MARKET, MD 21774-6943
(240) 643-2662
Mailing address
6994 MERLE CT, NEW MARKET, MD 21774-6943
(240) 643-2662
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
R223350
MD
Other
Enumeration date
03/21/2023
Last updated
03/21/2023
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