Individual
MR. JOHNSON O KOLAWOLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4903 ASHFORD DR, UPPR MARLBORO, MD 20772-2776
(240) 646-2891
Mailing address
11486 SAMUEL BECKETT CT, WHITE PLAINS, MD 20695-4254
(240) 646-2891
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
HHA200005883
DC
251E00000X
Home Health Agency
—
—
374U00000X
Home Health Aide
HHA200005883
DC
374U00000X
Home Health Aide
Primary
—
DC
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
10/30/2017
Last updated
04/16/2026
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