NPI 1417484965 · live from the CMS NPI Registry
Olusumbo Alade
Physician Assistant, Medical in Bel Air, MD. National Provider Identifier 1417484965, active.
NPI record
| NPI | 1417484965 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Physician Assistant, Medical 363AM0700X |
| Practice location | 500 Upper Chesapeake Dr, Bel Air, MD 21014 |
| Practice phone | 443-643-1500 |
| Mailing address | 7513 Stonecutter Ct, Apt C, Rosedale, MD 21237 |
| Enumerated | May 15, 2017 |
| Last updated | August 16, 2022 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Physician Assistant | 363A00000X | MA058996 (PA) |
| Physician Assistant, Medical primary | 363AM0700X | C0006476 (MD) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.