Individual
TITILAYO ADENIKE UNEGBU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2021 CROSS CHURCH WAY, MITCHELLVILLE, MD 20721-2398
(410) 440-8763
Mailing address
13106 CONTEE MANOR RD, BOWIE, MD 20721-3299
(410) 440-8763
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
MDR117409
MD
363LG0600X
Gerontology Nurse Practitioner
Primary
2022091446
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
U-521-793-031-832
DRIVER'S LICENSE
MD
Enumeration date
05/30/2018
Last updated
01/24/2023
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