Healthcare Provider Details

I. General information

NPI: 1114062775
Provider Name (Legal Business Name): MERCY A. OBAMOGIE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/21/2007
Last Update Date: 10/28/2025
Certification Date: 10/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7225 HANOVER PKWY STE A
GREENBELT MD
20770-2024
US

IV. Provider business mailing address

7225 HANOVER PKWY STE A
GREENBELT MD
20770-2024
US

V. Phone/Fax

Practice location:
  • Phone: 301-345-5900
  • Fax: 301-982-0484
Mailing address:
  • Phone: 301-345-5900
  • Fax: 301-982-0484

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberD0032657
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: