Provider Demographics
NPI:1528756277
Name:OSUJI, LINUS AZUNNA SR
Entity type:Individual
Prefix:
First Name:LINUS
Middle Name:AZUNNA
Last Name:OSUJI
Suffix:SR
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 1:2 BEESON CT APT K
Mailing Address - Street 2:
Mailing Address - City:NOTTINGHAM
Mailing Address - State:MD
Mailing Address - Zip Code:21236-4957
Mailing Address - Country:US
Mailing Address - Phone:443-801-3302
Mailing Address - Fax:
Practice Address - Street 1:2 BEESON CT APT K
Practice Address - Street 2:
Practice Address - City:NOTTINGHAM
Practice Address - State:MD
Practice Address - Zip Code:21236-4957
Practice Address - Country:US
Practice Address - Phone:443-801-3302
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-28
Last Update Date:2023-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR210316363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health