Individual
OLUSEYI ADEBOLA SOFOLUWE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNP
Contact information
Practice address
7610 CARROLL AVE STE 100, TAKOMA PARK, MD 20912-6311
(301) 891-2500
Mailing address
7610 CARROLL AVE STE 100, TAKOMA PARK, MD 20912-6311
(301) 891-2500
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
R177845
MD
363L00000X
Nurse Practitioner
RN1011899
DC
363LA2200X
Adult Health Nurse Practitioner
Primary
R177845
MD
Other
Enumeration date
05/27/2018
Last updated
05/07/2020
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