Healthcare Provider Details

I. General information

NPI: 1073330551
Provider Name (Legal Business Name): EASTERN SHORE MEDICAL CENTER MENTAL HEALTH & WELLNESS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/25/2024
Last Update Date: 09/25/2024
Certification Date: 09/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

914A EASTERN SHORE DR
SALISBURY MD
21804-6410
US

IV. Provider business mailing address

914A EASTERN SHORE DR
SALISBURY MD
21804-6410
US

V. Phone/Fax

Practice location:
  • Phone: 410-546-1331
  • Fax: 410-543-8107
Mailing address:
  • Phone: 410-546-1331
  • Fax: 410-543-8107

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DR. YOGESH VOHRA
Title or Position: OWNER
Credential: MD
Phone: 410-546-1331