Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0505X | Family Doctor - Adult Medicine | R212861 | MD |
NPI | 1336799634 |
---|---|
Provider Name | Abosede Adeniji Sakariyah |
First Address | Germantown, MD 20874-4110 |
Second Address | Germantown, MD 20874-4110 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/09/2019 |
Last Update Date | 21/09/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
R212861 | MARYLAND BOARD OF NURSING (01) | MD |
R212861 | R212861 (01) | MD |