Individual
MARY OLUBUNMI FAKOREDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
5200 EASTERN AVE FL W2, BALTIMORE, MD 21224-2757
(410) 550-2999
Mailing address
5200 EASTERN AVE FL W2, BALTIMORE, MD 21224-2757
(410) 550-2999
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
D0093734
MD
207QA0401X
Addiction Medicine (Family Medicine) Physician
Primary
D0093734
MD
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/26/2019
Last updated
07/27/2022
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