MEDICARE: FAMILY MEDICAL CLINIC INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner
2	363LP2300X	Primary Care Nurse Practitioner

General Provider Information

NPI Number	:	1528324274
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FAMILY MEDICAL CLINIC INC

Provider Business Mailing Address
First Line	:	1000 INGLESIDE AVE
Second Line	:
City	:	CATONSVILLE
State	:	MD
Zip	:	21228-1317
Country	:	US
Telephone Number	:	443-551-3784
Fax Number	:	443-551-3801

Provider Business Practice Location Address
First Line	:	1000 INGLESIDE AVE
Second Line	:
City	:	CATONSVILLE
State	:	MD
Zip	:	21228-1317
Country	:	US
Telephone Number	:	443-551-3784
Fax Number	:	443-551-3801

Authorized Official
Title or Position	:	CEO
Name	:	DR. PAULA UWAYEMEN OHIKU
Credential	:	DNP CRNP PMHNP
Telephone Number	:	443-551-3784

Provider Enumeration Date	:	04/06/2012
Last Update Date	:	12/19/2025

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