Active NPI
Ulumenfo Imoisili, M.D.
- Pediatrics Physician
- Laurel, MD
National Provider Identifier
1881630846
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- D0038524
- Practice address
- 7300 Van Dusen Rd
Laurel, MD 20707-9266 - Phone
- (301) 725-4300
- NPI assigned
- Jun 20, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | D0038524 | MD | Primary |
Addresses
Primary practice location
7300 Van Dusen Rd
Laurel, MD 20707-9266
Mailing address
8348 Kings Heights Rd
Ellicott City, MD 21043-6051
Phone (410) 465-6917
Other names 1
- Dr. Menfo Imoisili
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D0038524 | MD | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150761600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1881630846",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8348 KINGS HEIGHTS RD",
"city": "ELLICOTT CITY",
"state": "MD",
"postal_code": "210436051",
"telephone_number": "410-465-6917"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7300 VAN DUSEN RD",
"city": "LAUREL",
"state": "MD",
"postal_code": "207079266",
"telephone_number": "301-725-4300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IMOISILI",
"first_name": "ULUMENFO",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-20",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MD",
"license": "D0038524",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "MENFO",
"last_name": "IMOISILI",
"prefix": "DR.",
"code": "2",
"type": "Professional Name"
}
]
}Other providers in Laurel, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.