Individual
ISABELLA A AHANOGBE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1221 MERCANTILE LN, UPPER MARLBORO, MD 20774-5374
(301) 761-8155
Mailing address
1221 MERCANTILE LN, UPPER MARLBORO, MD 20774-5374
(301) 618-5500
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
042004
IA
207Q00000X
Family Medicine Physician
MT199390
PA
Other
Enumeration date
05/24/2011
Last updated
06/25/2021
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