MOTUNRAYO OMOLOYE ADEGORUSI NPI 1568941797

NPI Information

NPI: 1568941797
Provider Name: MOTUNRAYO OMOLOYE ADEGORUSI
Classification: Nurse Practitioner - 363LP2300X
Entity Type: Individual

Specialization: Primary Care

PECOS Registration: Yes

Address:
7800 HOUSE OF CORRECTIONS RD
JESSUP, MD
ZIP 20794
Phone: (410) 799-6100
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Motunrayo Omoloye Adegorusi is a primary care nurse practitioner in Jessup, MD. Motunrayo Omoloye Adegorusi NPI is 1568941797. The provider is registered as an individual entity type and is a single specialty group.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

7800 HOUSE OF CORRECTIONS RD
JESSUP, MD
ZIP 20794
Phone: (410) 799-6100

The NPI 1568941797 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Power Mobility Devices.

The enumeration date for this NPI number is 8/8/2018 and was last updated on 3/7/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LP2300X	Nurse Practitioner	Primary Care	R196811	MARYLAND	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	N92802	OTHER	MARYLAND	CDS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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