Individual
BOLADALE ADEBIMPE ADEBOGUN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
62 RIDGELAWN RD, REISTERSTOWN, MD 21136-3647
(443) 762-7949
Mailing address
62 RIDGELAWN RD, REISTERSTOWN, MD 21136-3647
(443) 762-7949
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
101104
MD
164W00000X
Licensed Practical Nurse
101104
MD
374U00000X
Home Health Aide
101104
MD
376K00000X
Nurse's Aide
Primary
101104
MD
Other
Enumeration date
03/03/2011
Last updated
03/03/2011
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