Provider Demographics
NPI:1467266775
Name:AGBOR-BAIYEE, NDIEA
Entity type:Individual
Prefix:
First Name:NDIEA
Middle Name:
Last Name:AGBOR-BAIYEE
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 1:3110 OLNEY SANDY SPRING RD
Mailing Address - Street 2:
Mailing Address - City:OLNEY
Mailing Address - State:MD
Mailing Address - Zip Code:20832-1408
Mailing Address - Country:US
Mailing Address - Phone:866-386-2727
Mailing Address - Fax:
Practice Address - Street 1:3110 OLNEY SANDY SPRING RD
Practice Address - Street 2:
Practice Address - City:OLNEY
Practice Address - State:MD
Practice Address - Zip Code:20832-1408
Practice Address - Country:US
Practice Address - Phone:866-386-2727
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-05
Last Update Date:2025-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR224365363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily