Provider Demographics
NPI:1679122139
Name:OPAWOYE, AISHAH (PHARMD)
Entity type:Individual
Prefix:
First Name:AISHAH
Middle Name:
Last Name:OPAWOYE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13320 LAUREL BOWIE RD
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20708-1508
Mailing Address - Country:US
Mailing Address - Phone:301-776-3660
Mailing Address - Fax:
Practice Address - Street 1:4511 GREENWOOD RD
Practice Address - Street 2:
Practice Address - City:BELTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20705-2628
Practice Address - Country:US
Practice Address - Phone:301-537-9142
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-08
Last Update Date:2020-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD26804183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist