Provider Demographics
NPI:1487793899
Name:OYALOWO, MARIE-THERESE NDIM (PHARMD,BCOP, RN)
Entity type:Individual
Prefix:
First Name:MARIE-THERESE
Middle Name:NDIM
Last Name:OYALOWO
Suffix:
Gender:F
Credentials:PHARMD,BCOP, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15431 EXCELSIOR DR
Mailing Address - Street 2:BOWIE TOWN CENTER
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20716-2208
Mailing Address - Country:US
Mailing Address - Phone:301-262-2877
Mailing Address - Fax:301-262-4488
Practice Address - Street 1:15431 EXCELSIOR DR
Practice Address - Street 2:BOWIE TOWN CENTER
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20716-2208
Practice Address - Country:US
Practice Address - Phone:301-262-2877
Practice Address - Fax:301-262-4488
Is Sole Proprietor?:No
Enumeration Date:2007-02-05
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD119941835X0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835X0200XPharmacy Service ProvidersPharmacistOncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD4519470001Medicare ID - Type UnspecifiedPART B-DME
4519470001Medicare ID - Type UnspecifiedPART B-DME