Healthcare Provider Details

I. General information

NPI: 1154245785
Provider Name (Legal Business Name): OFEK OVADIA DNP, PMHNP-BC, CRNP-
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/06/2026
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8945 GUILFORD RD STE 140
COLUMBIA MD
21046-2638
US

IV. Provider business mailing address

8945 GUILFORD RD STE 140
COLUMBIA MD
21046-2638
US

V. Phone/Fax

Practice location:
  • Phone: 240-429-5248
  • Fax:
Mailing address:
  • Phone: 240-429-5248
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberR255260
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: