Oluwatosin Peter Omole
Individual provider Active NPI Student in an Organized Health Care Education/Training Program · White Marsh, MD
NPI 1710820113 · NPPES record last updated Apr 10, 2026
Key facts
- NPI
- 1710820113
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Student in an Organized Health Care Education/Training Program 390200000X
- License
- R197286 (MD)
- Practice address
- 5625 Harvey CT
White Marsh, MD 21162-1938 - Phone
- (443) 801-1882
- NPI assigned
- Apr 10, 2026
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R197286 | MD | MD | Student in an Organized Health Care Education/Training Program |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | R197286 | MD | Yes |
Addresses
Primary practice location
5625 Harvey CT
White Marsh, MD 21162-1938
Mailing address
5625 Harvey CT
White Marsh, MD 21162-1938
Phone (443) 801-1882
Other providers in White Marsh, MD
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- Michelle Okafor
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- Famous Iwinosa Osasuyi
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- Cynthia Lynn Pixton
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All providers in White Marsh, MD · Student in an Organized Health Care Education/Training Program in Maryland
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 10, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.