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

LicenseStateTypeSpecialty
R197286MDMDStudent in an Organized Health Care Education/Training Program

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
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

All providers in White Marsh, MD · Student in an Organized Health Care Education/Training Program in Maryland

Sources for this page

Verify at the official NPI Registry.