Individual
JEROME OBIAGBA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6604 SPRINGCREST DR, GREENBELT, MD 20770-3061
(202) 725-0208
Mailing address
6604 SPRINGCREST DR, GREENBELT, MD 20770-3061
(202) 725-0208
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
R197232
MD
Other
Enumeration date
01/12/2022
Last updated
01/12/2022
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