Active NPI
Malinda Ehimwenma Agbonavbare
- Pharmacist
- Owings Mills, MD
National Provider Identifier
1972790137
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 14916
- Practice address
- 11409 Cronhill Dr
Owings Mills, MD 21117-6219 - Phone
- (410) 559-5237
- NPI assigned
- Oct 1, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 14916 | MD | Primary |
Addresses
Primary practice location
11409 Cronhill Dr
Owings Mills, MD 21117-6219
Mailing address
2106 Kalb Manor Rd
Windsor Mill, MD 21244-2617
Phone (410) 281-2130
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14916 | MD | MD | Pediatric Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1191196800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1191196800000",
"number": "1972790137",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2106 KALB MANOR RD",
"city": "WINDSOR MILL",
"state": "MD",
"postal_code": "212442617",
"telephone_number": "410-281-2130"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11409 CRONHILL DR",
"city": "OWINGS MILLS",
"state": "MD",
"postal_code": "211176219",
"telephone_number": "410-559-5237"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AGBONAVBARE",
"first_name": "MALINDA",
"middle_name": "EHIMWENMA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-10-01",
"last_updated": "2007-10-01",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MD",
"license": "14916",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Owings Mills, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 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.