Provider Demographics
NPI:1447689591
Name:GBADEGESIN, RASHEED
Entity type:Individual
Prefix:
First Name:RASHEED
Middle Name:
Last Name:GBADEGESIN
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 1:1103 GLEN WILLOW DR
Mailing Address - Street 2:APT 4
Mailing Address - City:SEAT PLEASANT
Mailing Address - State:MD
Mailing Address - Zip Code:20743-1561
Mailing Address - Country:US
Mailing Address - Phone:240-694-7734
Mailing Address - Fax:
Practice Address - Street 1:1103 GLEN WILLOW DR
Practice Address - Street 2:APT 4
Practice Address - City:SEAT PLEASANT
Practice Address - State:MD
Practice Address - Zip Code:20743-1561
Practice Address - Country:US
Practice Address - Phone:240-694-7734
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-08
Last Update Date:2013-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide