| Mr Stephen Olomukoro, | |
|
5401 Old Court Rd, Randallstown, MD 21133-5103 | |
| (410) 521-2200 | |
| Not Available |
| Full Name | Mr Stephen Olomukoro |
|---|---|
| Gender | Male |
| Speciality | Certified Registered Nurse Anesthetist (crna) |
| Experience | 17 Years |
| Location | 5401 Old Court Rd, Randallstown, Maryland |
| Accepts Medicare Assignments | May be. He may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306175633 | NPI | - | NPPES |
| 030075600 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 163W00000X | Registered Nurse | R152983 (Maryland) | Secondary |
| 367500000X | Nurse Anesthetist, Certified Registered | R152983 (Maryland) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Johns Hopkins Bayview Medical Center | Baltimore, MD | Hospital |
| Meritus Medical Center | Hagerstown, MD | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Meritus Medical Center Inc | 7113811795 | 563 |
| Johns Hopkins University | 8921903147 | 2699 |
| Entity Name | Johns Hopkins University |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1922008549 PECOS PAC ID: 8921903147 Enrollment ID: O20031215000719 |
| Entity Name | Meritus Medical Center Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1205176393 PECOS PAC ID: 7113811795 Enrollment ID: O20040212000950 |
| Entity Name | North American Partners In Anesthesia Maryland Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1093707879 PECOS PAC ID: 1850283144 Enrollment ID: O20040330000405 |
| Entity Name | First Colonies Anesthesia Associates, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1740218767 PECOS PAC ID: 8426039744 Enrollment ID: O20040525000119 |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Stephen Olomukoro, 11781 Lee Jackson Memorial Hwy, Suite 550, Fairfax, VA 22033-3309 Ph: (571) 777-5157 | Mr Stephen Olomukoro, 5401 Old Court Rd, Randallstown, MD 21133-5103 Ph: (410) 521-2200 |
Tonya M. Pease, CRNA Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 5401 Old Court Rd, Randallstown, MD 21133 Phone: 410-496-7572 | |
Mrs. Jessica Audrey Webster Medalis, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 5401 Old Court Rd, Randallstown, MD 21133 Phone: 410-701-4547 Fax: 410-701-4342 | |
Verna Thomas, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 5401 Old Court Rd, Randallstown, MD 21133 Phone: 410-521-2200 | |
Shannon Quinn Hagan, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 5401 Old Court Rd, Randallstown, MD 21133 Phone: 410-701-4547 Fax: 410-701-4342 | |
Sucheep Piyasirisilp, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 5401 Old Court Rd, Randallstown, MD 21133 Phone: 410-521-2200 | |
Elizabeth J Iannazzo, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 5401 Old Court Rd, Randallstown, MD 21133 Phone: 410-496-7154 | |
Kaia Finney, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 5401 Old Court Rd, Randallstown, MD 21133 Phone: 410-521-2200 |