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General NPI Number Information
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NPI Number | 1821512591
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Entity Type | Organization
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Legal Business Name | DOMINION HEALTHCARE SERVICES INC
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Dates
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Enumeration Date | 08/03/2017
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Last Update Date | 11/04/2024
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Provider Practice Location Address
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Address Line | 6481 ABEL ST
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City | ELKRIDGE
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State | MD
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Zip | 21075-5298
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Country | US
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Telephone | 443-848-9123
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Fax | 410-796-1442
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Provider Business Mailing Address
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Address Line | 6481 ABEL ST
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City | ELKRIDGE
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State | MD
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Zip | 21075-5298
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Country | US
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Telephone | 443-848-9123
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Fax | 410-796-1442
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | MRS. ANGELA OBENG AWUAH
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Credential | CRNP
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Telephone | 443-848-9123
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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