Healthcare Provider Details
I. General information
NPI: 1174477335
Provider Name (Legal Business Name): DENOOR HEALTHCARE SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/24/2026
Last Update Date: 03/19/2026
Certification Date: 03/19/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1935-1937 WEST PRATT ST FIRST FLOOR
BALTIMORE MD
21223
US
IV. Provider business mailing address
1935-1937 WEST PRATT ST FIRST FLOOR
BALTIMORE MD
21223
US
V. Phone/Fax
- Phone: 571-232-9182
- Fax:
- Phone: 571-232-9182
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207QA0000X |
| Taxonomy | Adolescent Medicine (Family Medicine) Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207QA0401X |
| Taxonomy | Addiction Medicine (Family Medicine) Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207QG0300X |
| Taxonomy | Geriatric Medicine (Family Medicine) Physician |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QP2300X |
| Taxonomy | Primary Care Clinic/Center |
| License Number | |
| License Number State | |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
KAFAYAT
OLABISI
BELLO-OGUNDIPE
Title or Position: DIRECTOR
Credential: CRNP
Phone: 571-232-9182