Individual
KOFOWOROLA BALOGUN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MBI HEALTH SERVICES
Contact information
Practice address
4130 HUNT PL NE, WASHINGTON, DC 20019-3565
(202) 388-9202
Mailing address
309 EAGLES RIDGE WAY, GLEN BURNIE, MD 21061-6754
(240) 938-3395
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
251B00000X
Case Management Agency
—
—
Other
Enumeration date
04/21/2013
Last updated
03/16/2023
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