MRS. OLUKEMI ANTONIA MOREIRA-WILSON (NPI# 1255644423) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255644423 |
| Entity Type | Individual |
| Full Name | MRS. OLUKEMI ANTONIA MOREIRA-WILSON |
| Other Name | MISS OLUKEMI ANTONIA MOREIRA |
| Credential | PA-C |
| Practice Address |
605 Post Office Rd Suite 102 Waldorf MD 20602-1913 |
| Practice Telephone | 3013742666 |
| Practice Fax Number | 3013742662 |
| Mailing Telephone | 3013742666 |
| Mailing Fax Number | 3013742662 |
| Enumeration Date | 2010-07-16 |
| Last Update Date | 2011-02-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | C0004263 | MD | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
605 POST OFFICE RD SUITE 102 |
| City | WALDORF |
| State | MD |
| Zip Code | 20602-1913 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083711733 | Adeteju Ogunrinde | Pediatrics | 605 Post Office Rd, Suite 102, Waldorf, MD 20602-1913 | 2006-09-17 |
| 1538515309 | Agent of Change, LLC | Social Worker | 605 Post Office Rd, Suite 301, Waldorf, MD 20602-1913 | 2016-05-10 |
| 1679949416 | Michelle Laporte Jackson | Physician Assistant | 605 Post Office Rd, Suite 102, Waldorf, MD 20602-1913 | 2015-08-17 |
| 1588097265 | Jordan Bebber | Physician Assistant | 605 Post Office Rd, Suite 102, Waldorf, MD 20602-1913 | 2013-08-16 |
| 1801074281 | Yaromyr Oryshkevych | Dentist | 605 Post Office Rd, Suite 203, Waldorf, MD 20602-1913 | 2008-02-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053964957 | Haeyoung Choi | Pharmacist | 25 Smallwood Village Center, Waldorf, MD 20602 | 2019-07-19 |
| 1679137194 | Brighter Days Family Services Inc | Counselor | 11680 Doolittle Dr #111, Waldorf, MD 20602 | 2019-04-30 |
| 1396227039 | Lantern Family Services Inc | Community/Behavioral Health | 11680 Doolittle Dr Ste 111, Waldorf, MD 20602 | 2018-08-29 |
| 1093294910 | Metropolitan Vascular Institute LLC | Internal Medicine | 12070 Old Line Ctr Ste 100, Waldorf, MD 20602 | 2018-08-10 |
| 1174009922 | Dr. Arthur B. Sorkin, D.d.s., LLC | Dentist | 3460 Old Washington Rd., Suite 301-b, Waldorf, MD 20602 | 2018-07-16 |
| 1467945030 | Donna Marie Conley-shaw | Behavior Technician | 16 Pagnell Cir, Waldorf, MD 20602 | 2018-06-08 |
| 1811404296 | Loni Berbaum | Speech-Language Pathologist | 4817 Elmley Pl Apt 315, Waldorf, MD 20602 | 2018-01-06 |
| 1891224853 | Linda E Smith | Social Worker | 605 Pst Office Road, #301, Waldorf, MD 20602 | 2017-06-05 |
| 1104373273 | Love Ngum Che | Pharmacist | 25 Smallwood Village, Waldorf, MD 20602 | 2016-09-07 |
| 1639543341 | Matengy Toure | Pharmacist | 129 St Charles Pkwy, Waldorf, MD 20602 | 2015-11-18 |
| Find all providers in zip 20602 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629553383 | Deasia Henderson | Physician Assistant | 3460 Old Washington Rd Ste 300, Waldorf, MD 20602-3245 | 2018-09-28 |
| 1215448360 | Joanna Goyette Smith | Physician Assistant | 102 Paul Mellon Ct Ste 102, Waldorf, MD 20602-2793 | 2017-10-17 |
| 1346642311 | Heather Leigh Pridgen Powell | Physician Assistant | 11637 Terrace Dr Ste 100, Waldorf, MD 20602-3707 | 2014-09-22 |
| 1619386471 | Sabena Juzer Modi-masood | Physician Assistant | 102 Paul Mellon Ct Suite 102, Waldorf, MD 20602-2788 | 2014-08-06 |
| 1255676086 | Abeba A. Tadesse | Physician Assistant | 12070 Old Line Center, Suite 210, Waldorf, MD 20602-2567 | 2012-12-05 |
| 1356614655 | Bemnet Zeleke Zeleke | Physician Assistant | 7 Post Office Rd # 7c, Waldorf, MD 20602-2744 | 2012-02-16 |
| 1023385457 | Kristen Elise Lohr | Physician Assistant | 12090 Old Line Centre, Waldorf, MD 20602 | 2011-11-30 |
| 1407059967 | Carla D. Hines | Physician Assistant | 12070 Old Line Center Drive, Suite 210, Waldorf, MD 20602 | 2007-06-11 |
| 1629079454 | S Michelle Thornblade | Physician Assistant | 3975 Saint Charles Pkwy, Waldorf, MD 20602-2683 | 2005-08-02 |
| 1700386711 | Jenelle Sills Fleming | Physician Assistant | 11315 Pembrooke Sq Ste 111, Waldorf, MD 20603-4806 | 2018-02-16 |
| Find all providers in WALDORF | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.