Organization
MERCY HEALTH PATHWAY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
OLATUNJI IBERU-OLUSHOGA CRNP (OWNER)
(301) 728-0345
Entity
Organization
Contact information
Practice address
1509 FITZPATRICK DR, SEVERN, MD 21144-3142
(301) 728-0345
Mailing address
1509 FITZPATRICK DR, SEVERN, MD 21144-3142
(301) 728-0345
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
—
—
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Enumeration date
06/02/2023
Last updated
06/02/2023
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