Provider Demographics
NPI:1174065650
Name:WOGHIREN, OSAKPOLOR EMMANUEL (PHARM D, MBA)
Entity type:Individual
Prefix:
First Name:OSAKPOLOR
Middle Name:EMMANUEL
Last Name:WOGHIREN
Suffix:
Gender:M
Credentials:PHARM D, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7005 LACHLAN CIR
Mailing Address - Street 2:APT A
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21239-1031
Mailing Address - Country:US
Mailing Address - Phone:857-636-8583
Mailing Address - Fax:
Practice Address - Street 1:7005 LACHLAN CIR
Practice Address - Street 2:APT A
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21239-1031
Practice Address - Country:US
Practice Address - Phone:857-636-8583
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-15
Last Update Date:2016-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD24627183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist