NPIMap

Organization Active NPI

Debobeth Medical Center

  • Health Service Clinic/Center
  • Baltimore, MD
National Provider Identifier
1043791122
Registry record updated Apr 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
License
W18743245 Issued in MD
Legal business name
DEBOBETH MEDICAL CENTER
Practice address
3109 Erdman Ave
Baltimore, MD 21213-1765
Phone
(443) 904-5129
NPI assigned
Aug 27, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mercy Fadoju
Title
Provider
Phone
(443) 904-5129

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X W18743245 MD Primary

Addresses

Primary practice location

3109 Erdman Ave
Baltimore, MD 21213-1765

Mailing address

3109 Erdman Ave
Baltimore, MD 21213-1765
Phone (443) 904-5129

Other identifiers 1

IdentifierTypeStateIssuer
168716600MedicaidMD

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1535328000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776384000000",
    "number": "1043791122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3109 ERDMAN AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212131765",
            "telephone_number": "443-904-5129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3109 ERDMAN AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212131765",
            "telephone_number": "443-904-5129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEBOBETH MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-27",
        "last_updated": "2026-04-17",
        "certification_date": "2026-04-17",
        "status": "A",
        "authorized_official_last_name": "FADOJU",
        "authorized_official_first_name": "MERCY",
        "authorized_official_title_or_position": "PROVIDER",
        "authorized_official_telephone_number": "443-904-5129"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "MD",
            "license": "W18743245",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "168716600",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.