DEBOBETH MEDICAL CENTER (NPI# 1043791122) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043791122 |
| Entity Type | Organization |
| Organization Name | DEBOBETH MEDICAL CENTER |
| Practice Address |
3107 Erdman Ave Baltimore MD 21213-1719 |
| Mailing Address |
2144 Chantilla Rd Baltimore MD 21228-3703 |
| Practice Telephone | 4439045129 |
| Mailing Telephone | 4439045129 |
| Enumeration Date | 2018-08-27 |
| Last Update Date | 2018-08-27 |
| Authorized Official Name | MERCY FADOJU (PROVIDER) |
| Authorized Official Telephone | 4439045129 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QH0100X |
Clinic/Center Specialization: Health Service |
W18743245 | MD | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MD | 168716600 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225651433 | Debobeth Medical Center | Clinic/Center | 3107-3109 Erdman Avenue, Baltimore, MD 21213 | 2020-05-21 |
| 1871074096 | Debobeth Medical Center | Nurse Practitioner | 3107 Erdman Ave, Baltimore, MD 21213-1719 | 2018-08-25 |
| 1508489758 | Debobeth Medical Center | Psychiatry & Neurology | 3107-3109 Erdman Avenue, Baltimore, MD 21213 | 2020-05-22 |
| 1447873690 | Debobeth Medical Center | Psychiatry & Neurology | 3107-3109 Erdman Avenue, Baltimore, MD 21213 | 2020-05-22 |
| 1255954400 | Debobeth Medical Center | Psychiatry & Neurology | 3107-3109 Erdman Avenue, Baltimore, MD 21213 | 2020-05-22 |
| 1285255935 | Debobeth Medical Center | Psychiatry & Neurology | 3109 Erdman Ave, Baltimore, MD 21213-1719 | 2020-05-05 |
| 1467087031 | Debobeth Medical Center | Psychiatry & Neurology | 3109 Erdman Ave, Baltimore, MD 21213-1719 | 2020-03-04 |
| 1174155733 | Debobeth Medical Center | Psychiatry & Neurology | 3109 Erdman Ave, Baltimore, MD 21213-1719 | 2020-02-11 |
| 1023640604 | Debobeth Medical Center | Psychiatry & Neurology | 3109 Erdman Ave, Baltimore, MD 21213-1719 | 2020-02-11 |
| 1336771922 | Debobeth Medical Center | Psychiatry & Neurology | 3109 Erdman Ave, Baltimore, MD 21213-1719 | 2020-02-11 |
| Street Address |
3107 ERDMAN AVE |
| City | BALTIMORE |
| State | MD |
| Zip Code | 21213-1719 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871074096 | Debobeth Medical Center | Nurse Practitioner | 3107 Erdman Ave, Baltimore, MD 21213-1719 | 2018-08-25 |
| 1790328268 | Christianah Bosede Egiefameh | Nurse Practitioner | 3107 Erdman Ave, Baltimore, MD 21213-1719 | 2019-10-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225651433 | Debobeth Medical Center | Clinic/Center | 3107-3109 Erdman Avenue, Baltimore, MD 21213 | 2020-05-21 |
| 1538627807 | Beverly V Whittaker-mcdermott | Social Worker | 3007 E. Biddle Street, Baltimore, MD 21213 | 2019-03-06 |
| 1164926085 | Redeem Healthcare and Medical System Inc | Clinic/Center | 3240 Belair Rd Fl 1, Baltimore, MD 21213 | 2018-03-23 |
| 1700398914 | Ags Programs LLC | Clinic/Center | 1807 E. Preston Street, Wolfe Street Suite, Baltimore, MD 21213 | 2017-10-27 |
| 1558883918 | Dayspring Programs, Inc. | Substance Abuse Rehabilitation Facility | 1125 N. Patterson Park Avenue, Baltimore, MD 21213 | 2017-07-07 |
| 1699205294 | Live & Let Live LLC | Counselor | 3549 Elmley Avenue, Baltimore, MD 21213 | 2017-06-15 |
| 1174052518 | Vel J Humbert | Counselor | 3549 Elmley Ave, Baltimore, MD 21213 | 2017-06-08 |
| 1134676620 | Larry Kirkland | Counselor | 3051 Sinclair Lane, Baltimore, MD 21213 | 2016-09-01 |
| 1093170862 | Renewed Minds Therapeutic Services LLC | Clinic/Center | 1515 E Biddle Street, Baltimore, MD 21213 | 2015-12-22 |
| 1073980827 | Family Therapy Services,llc | Counselor | 3238-40 Belair Road, 2nd Floor, Baltimore, MD 21213 | 2015-08-27 |
| Find all providers in zip 21213 | ||||
| Taxonomy Code | 261QH0100X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Health Service |
| Definition to come... |
| Notes: [7/1/2006: modified title] |
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| 1144714536 | Sweet Air Acupuncure | Clinic/Center | 4803 Yellowwood Ave, Baltimore, MD 21209-4622 | 2018-06-19 |
| 1902318124 | Angel Hands Healthcare Services, LLC | Clinic/Center | 6600 York Rd Ste 207, Baltimore, MD 21212-2024 | 2017-10-27 |
| 1194279356 | Bnj Counseling Services, LLC | Clinic/Center | 2701 Washington Blvd, Baltimore, MD 21230-1410 | 2016-08-05 |
| 1689042541 | Jr Health Care Associates, LLC | Clinic/Center | 2310 N Charles St, Baltimore, MD 21218-5127 | 2015-09-09 |
| Find all providers in BALTIMORE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.