Organization
TLC OBGYN AND COSMETIC SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. OLUBUSOLA OGUNLADE MD (MD)
(302) 264-6848
Entity
Organization
Contact information
Practice address
7414 QUAIL RIDGE LN, BOWIE, MD 20720-4352
(302) 264-6848
Mailing address
7414 QUAIL RIDGE LN, BOWIE, MD 20720-4352
Taxonomy
Speciality
Code
Description
License number
State
207NS0135X
Procedural Dermatology Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
207VG0400X
Gynecology Physician
—
—
207VX0000X
Obstetrics Physician
—
—
208200000X
Plastic Surgery Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1194046375
NPI
—
Enumeration date
10/05/2017
Last updated
10/05/2017
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