Individual
IFEDAYO OSUNTUYI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2021 W PRATT ST, BALTIMORE, MD 21223-2242
(410) 566-1360
Mailing address
3808 ENDERS LN, BOWIE, MD 20716-7330
(301) 351-0514
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
16305
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
O253331660817
DRIVERS LICENSE
MD
Enumeration date
06/20/2018
Last updated
06/20/2018
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