DEBOBETH MEDICAL CENTER (NPI# 1174155733) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174155733 |
| Entity Type | Organization |
| Organization Name | DEBOBETH MEDICAL CENTER |
| Practice Address |
3109 Erdman Ave Baltimore MD 21213-1719 |
| Practice Telephone | 4439045129 |
| Practice Fax Number | 4108694603 |
| Mailing Telephone | 4439045129 |
| Enumeration Date | 2020-02-11 |
| Last Update Date | 2020-02-11 |
| Authorized Official Name | MERCY O FADOJU (DIRECTOR) |
| Authorized Official Telephone | 4108694602 |
| Is Organization Subpart | Y |
| Parent Organization Name | DEBOBETH MEDICAL CENTER |
| Parent Organization TIN |
|
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084B0040X |
Psychiatry & Neurology Specialization: Behavioral Neurology & Neuropsychiatry |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| OMHC | Doing Business As Name - Organization |
| 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 |
| 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 |
| 1043791122 | Debobeth Medical Center | Clinic/Center | 3107 Erdman Ave, Baltimore, MD 21213-1719 | 2018-08-27 |
| Street Address |
3109 ERDMAN AVE |
| City | BALTIMORE |
| State | MD |
| Zip Code | 21213-1719 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083184360 | Erdman Avenue Pharmacy | Pharmacy | 3109 Erdman Ave, Baltimore, MD 21213-1719 | 2018-11-29 |
| 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 |
| 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 |
| 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 | 2084B0040X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Behavioral Neurology & Neuropsychiatry |
| Behavioral Neurology & Neuropsychiatry is a medical subspecialty involving the diagnosis and treatment of neurologically based behavioral issues. |
| Notes: Source: National Uniform Claim Committee. [1/1/2012: new] Additional Resources: American Academy of Neurology, www.aan.com. |
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|---|---|---|---|---|
| 1295334506 | Suuna Chi Healthcare Services, LLC | Psychiatry & Neurology | 6609 Reisterstown Rd Ste 201, Baltimore, MD 21215-2634 | 2020-10-19 |
| 1144820200 | Suuna Chi Healthcare Services, LLC | Psychiatry & Neurology | 6609 Reisterstown Rd Ste 201, Baltimore, MD 21215-2634 | 2020-10-28 |
| 1447873690 | 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 |
| 1972124816 | Faith Health Care Center | Psychiatry & Neurology | 413 Commonwealth Ave Ste 7, Baltimore, MD 21228-3044 | 2020-05-01 |
| 1619507100 | University of Maryland Neurology Associates, P.a. | Psychiatry & Neurology | 16 S Eutaw St Fl 3, Baltimore, MD 21201-1606 | 2020-01-23 |
| 1043859622 | Momentum Health Consultants, LLC | Psychiatry & Neurology | 5525 Belair Rd, Baltimore, MD 21206-3654 | 2019-12-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104464924 | Psychiatric Center of Northern Virginia | Psychiatry & Neurology | 13617 Query Mill Rd, North Potomac, MD 20878-3967 | 2019-12-11 |
| 1821511551 | Anu Healthcare Services Inc | Psychiatry & Neurology | 4809 Belair Road, Baltimore, Maryland, MD 21206 | 2017-07-25 |
| 1114165800 | Jonathan Pittman Wolf | Psychiatry & Neurology | 1644 Piccard Dr, Rockville, MD 20850-6693 | 2009-02-03 |
| 1083213854 | Imperial Psychiatric Services LLC | Psychiatry & Neurology | 547 Riverside Dr Ste A, Salisbury, MD 21801-5369 | 2020-10-22 |
| 1396353678 | Suuna Chi Healthcare Services, LLC | Psychiatry & Neurology | 13639 Baltimore Ave, Laurel, MD 20707-5095 | 2020-07-22 |
| 1306187752 | Potomac Regional Tms Center, Inc | Psychiatry & Neurology | 134 Baltimore St, Cumberland, MD 21502-2302 | 2013-03-11 |
| 1700956810 | Naveen Maddineni | Psychiatry & Neurology | 12073 Tech Rd, Silver Spring, MD 20904-7873 | 2006-11-08 |
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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.