Provider Demographics
NPI:1083403422
Name:BARUWA, LUKMAN ISHOLA
Entity type:Individual
Prefix:
First Name:LUKMAN
Middle Name:ISHOLA
Last Name:BARUWA
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1110 CAPE TEAL CT
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20774-7082
Mailing Address - Country:US
Mailing Address - Phone:347-235-7623
Mailing Address - Fax:
Practice Address - Street 1:1110 CAPE TEAL CT
Practice Address - Street 2:
Practice Address - City:UPPER MARLBORO
Practice Address - State:MD
Practice Address - Zip Code:20774-7082
Practice Address - Country:US
Practice Address - Phone:347-235-7623
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-02
Last Update Date:2025-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide