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General NPI Number Information
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NPI Number | 1760417307
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Entity Type | Individual
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Provider Name | CYNTHIA JEONA FOLSOME MD
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Gender | Female
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Dates
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Enumeration Date | 07/12/2006
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Last Update Date | 08/30/2022
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Provider Practice Location Address
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Address Line | 1662 VILLAGE GRN # 100
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City | CROFTON
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State | MD
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Zip | 21114-2014
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Country | US
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Telephone | 410-757-2077
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Fax |
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Provider Business Mailing Address
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Address Line | 1925 WOODSHADE CT
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City | BOWIE
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State | MD
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Zip | 20721-4113
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Country | US
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Telephone | 240-472-3155
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | C53922
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | D0059684
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License Number State | MD
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