Provider Demographics
NPI:1154973311
Name:SHOWUNMI, ADEBISI OLUBUNMI
Entity type:Individual
Prefix:
First Name:ADEBISI
Middle Name:OLUBUNMI
Last Name:SHOWUNMI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3500 SUGAR MAPLE CT
Mailing Address - Street 2:
Mailing Address - City:WALDORF
Mailing Address - State:MD
Mailing Address - Zip Code:20602-2625
Mailing Address - Country:US
Mailing Address - Phone:301-395-7874
Mailing Address - Fax:
Practice Address - Street 1:3500 SUGAR MAPLE CT
Practice Address - Street 2:
Practice Address - City:WALDORF
Practice Address - State:MD
Practice Address - Zip Code:20602-2625
Practice Address - Country:US
Practice Address - Phone:301-395-7874
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-09
Last Update Date:2019-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR138200163WC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine