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General NPI Number Information
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NPI Number | 1922664739
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Entity Type | Organization
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Legal Business Name | CENTRAL MARYLAND PSYCHIATRIC CARE LIMITED LIABILITY COMPANY
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Dates
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Enumeration Date | 05/16/2019
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Last Update Date | 05/16/2019
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Provider Practice Location Address
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Address Line | 2444 SOLOMONS ISLAND RD STE 205
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City | ANNAPOLIS
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State | MD
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Zip | 21401-3719
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Country | US
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Telephone | 667-300-8884
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Fax |
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Provider Business Mailing Address
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Address Line | 6030 DAYBREAK CIR STE A150-121
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City | CLARKSVILLE
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State | MD
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Zip | 21029-1642
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Country | US
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Telephone | 667-300-8884
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | DR. MELANIE OGUNMEFUN
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Credential | MD
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Telephone | 667-300-8884
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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 |
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License Number State |
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