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General NPI Number Information
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NPI Number | 1083142780
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Entity Type | Organization
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Legal Business Name | CITYCARE FAMILY PRACTICE & URGENT CARE SERVICES INC
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Dates
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Enumeration Date | 05/25/2017
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Last Update Date | 10/13/2022
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Provider Practice Location Address
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Address Line | 260 GATEWAY DR STE 17-18B
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City | BEL AIR
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State | MD
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Zip | 21014-4268
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Country | US
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Telephone | 443-787-4228
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Fax | 443-787-4263
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Provider Business Mailing Address
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Address Line | 260 GATEWAY DR STE 17-18B
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City | BEL AIR
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State | MD
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Zip | 21014-4268
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Country | US
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Telephone | 443-787-4228
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Fax | 443-787-4263
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | OLADIMEJI ADEDIRE
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Credential |
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Telephone | 410-383-9976
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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