Individual
DR. MARY OGUNSANYA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
12150 ANNAPOLIS RD, SUITE 208, GLENN DALE, MD 20769-9183
(301) 218-0398
Mailing address
PO BOX 2132, BOWIE, MD 20718-2132
(301) 218-0398
(301) 218-0040
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
D005630
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30240320
—
MD
Enumeration date
06/27/2006
Last updated
02/09/2012
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