Organization · NPI-2

Bayside Behavioral Health Clinic Of

Psychiatry & Neurology, Psychiatry · Annapolis, MD

NPI number1215093786
StatusActive
Last updated in NPPESOct 26, 2020

Details

NPI
1215093786
Entity type
Organization (NPI-2)
Legal business name
Bayside Behavioral Health Clinic Of
Organization subpart
No
Enumeration date
Dec 29, 2006
Certification date
Oct 26, 2020
Last updated
Oct 26, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
2084P0800X Psychiatry & Neurology, Psychiatry––Yes
2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry––
2084P0805X ––

Practice location

2444 Solomons Island Rd Ste 205
Annapolis, MD 21401-3723

Phone 410-292-4559

Mailing address

Po Box 6250
Ellicott City, MD 21042-0250

Phone 410-292-4559

Authorized official

Adeleke A Ogunmefun
Managing Member
4102924559

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