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General NPI Number Information
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NPI Number | 1386506491
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Entity Type | Organization
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Legal Business Name | DELUXMED HEALTH GROUP, LLC
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Dates
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Enumeration Date | 11/26/2025
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Last Update Date | 02/27/2026
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Provider Practice Location Address
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Address Line | 1503 E NORTH AVE
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City | BALTIMORE
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State | MD
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Zip | 21213-1408
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Country | US
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Telephone | 240-780-8930
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Fax |
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Provider Business Mailing Address
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Address Line | 19426 FISHER AVE
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City | POOLESVILLE
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State | MD
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Zip | 20837-2256
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Country | US
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Telephone | 240-780-8930
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Fax |
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER (CEO)
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Name | DOREEN ACKOM-OWUSU
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Credential |
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Telephone | 240-780-8930
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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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 | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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Taxonomy #3
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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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Taxonomy #4
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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