Provider Demographics
NPI:1497644348
Name:TETEDE, MARZUCK OLORUNCHOLA
Entity type:Individual
Prefix:
First Name:MARZUCK OLORUNCHOLA
Middle Name:
Last Name:TETEDE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5804 ANNAPOLIS RD APT 411
Mailing Address - Street 2:
Mailing Address - City:BLADENSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20710-2012
Mailing Address - Country:US
Mailing Address - Phone:240-536-5435
Mailing Address - Fax:
Practice Address - Street 1:5804 ANNAPOLIS RD APT 411
Practice Address - Street 2:
Practice Address - City:BLADENSBURG
Practice Address - State:MD
Practice Address - Zip Code:20710-2012
Practice Address - Country:US
Practice Address - Phone:240-536-5435
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-02
Last Update Date:2025-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide