Omowunmi Maureen Anibaba, PHARMD
Individual provider Active NPI Pharmacist · Edgewood, MD
NPI 1962772525 · NPPES record last updated Jan 12, 2012
Key facts
- NPI
- 1962772525
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 20360 (MD)
- Practice address
- 702 Edgewood Rd
Edgewood, MD 21040-2400 - Phone
- (410) 671-9780
- NPI assigned
- Jan 12, 2012
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20360 | MD | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 20360 | MD | Yes |
Addresses
Primary practice location
702 Edgewood Rd
Edgewood, MD 21040-2400
Mailing address
9882 Decatur Rd
Middle River, MD 21220-3777
Phone (410) 790-4365
Other providers in Edgewood, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 12, 2012. 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.