Healthcare Provider Details

I. General information

NPI: 1942159850
Provider Name (Legal Business Name): MALAMA MEDICAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/23/2026
Last Update Date: 02/25/2026
Certification Date: 02/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8307 PHILADELPHIA RD STE A
ROSEDALE MD
21237-2961
US

IV. Provider business mailing address

8307 PHILADELPHIA RD STE A
BALTIMORE MD
21237-2961
US

V. Phone/Fax

Practice location:
  • Phone: 443-802-5130
  • Fax:
Mailing address:
  • Phone: 443-802-5130
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: MS. KIMELA J FERGUSON
Title or Position: CEO
Credential:
Phone: 443-902-8017