NPIMap

Organization Active NPI

Debobeth Medical Center

  • Psychiatry Physician
  • Baltimore, MD
National Provider Identifier
1508489758
Registry record updated May 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
DEBOBETH MEDICAL CENTER
Practice address
3107-3109 Erdman Avenue
Baltimore, MD 21213
Phone
(410) 869-4602
Fax
(410) 869-4603
NPI assigned
May 22, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 22, 2020

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

Authorized official

Name
Mercy O FadojuNPI 1962671313
Title
Provider
Phone
(410) 869-4602

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

3107-3109 Erdman Avenue
Baltimore, MD 21213

Mailing address

3107-3109 Erdman Avenue
Baltimore, MD 21213
Phone (410) 869-4602

National Provider Directory

National Provider Directory
Tax ID family
Debobeth Medical Center6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

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": "1590105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1590105600000",
    "number": "1508489758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3107-3109 ERDMAN AVENUE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "21213",
            "telephone_number": "410-869-4602",
            "fax_number": "410-869-4603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3107-3109 ERDMAN AVENUE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "21213",
            "telephone_number": "410-869-4602",
            "fax_number": "410-869-4603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEBOBETH MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-22",
        "last_updated": "2020-05-22",
        "certification_date": "2020-05-22",
        "status": "A",
        "authorized_official_last_name": "FADOJU",
        "authorized_official_first_name": "MERCY",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "PROVIDER",
        "authorized_official_telephone_number": "410-869-4602"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 May 22, 2020; 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.