Provider Demographics
NPI:1447049184
Name:SHOMORIN, OLANREWAJU
Entity type:Individual
Prefix:
First Name:OLANREWAJU
Middle Name:
Last Name:SHOMORIN
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 1:6614 SEWARD RD
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20720-3363
Mailing Address - Country:US
Mailing Address - Phone:240-879-6459
Mailing Address - Fax:
Practice Address - Street 1:6614 SEWARD RD
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20720-3363
Practice Address - Country:US
Practice Address - Phone:240-879-6459
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-30
Last Update Date:2025-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator