Healthcare Provider Details

I. General information

NPI: 1386506491
Provider Name (Legal Business Name): DELUXMED HEALTH GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/26/2025
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1503 E NORTH AVE
BALTIMORE MD
21213-1408
US

IV. Provider business mailing address

19426 FISHER AVE
POOLESVILLE MD
20837-2256
US

V. Phone/Fax

Practice location:
  • Phone: 240-780-8930
  • Fax:
Mailing address:
  • Phone: 443-452-3692
  • Fax: 443-560-0380

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DOREEN ACKOM-OWUSU
Title or Position: CHIEF EXECUTIVE OFFICER (CEO)
Credential:
Phone: 443-452-3692