Individual
MR. ADEWALE MARK BALOGUN
Active
Individual
MR. ADEWALE MARK BALOGUN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
642609-1
NY
164W00000X
Licensed Practical Nurse
2583711
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02151077
—
NY
Enumeration date
11/20/2006
Last updated
09/29/2021
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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