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Individual

DR. OLABISI A JAGUN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
12600 HILL CREEK LN, POTOMAC, MD 20854-1184
(240) 401-5953
Mailing address
12600 HILL CREEK LN, POTOMAC, MD 20854-1184
(240) 401-5953

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
0101046802
VA
207P00000X
Emergency Medicine Physician
Primary
MD16916
DC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
030100500
DC
05
1679522023
VA
05
3810007727
WV
Enumeration date
05/10/2006
Last updated
03/07/2023
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