| Marcellus R. Cephas, Md Llc | |
|
1405 Madison Park Dr Suite 1b Glen Burnie MD 21061-5627 | |
| (410) 487-6302 | |
| (301) 891-2080 |
| Full Name | Marcellus R. Cephas, Md Llc |
|---|---|
| Speciality | Psychologist - Prescribing (medical) |
| Location | 1405 Madison Park Dr, Glen Burnie, Maryland |
| Authorized Official Name and Position | Marcellus Cephas (MEDICAL DIRECTOR) |
| Authorized Official Contact | 3018912077 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Marcellus R. Cephas, Md Llc 7610 Carroll Ave Ste 200 Takoma Park MD 20912-6312 Ph: (301) 891-2077 | Marcellus R. Cephas, Md Llc 1405 Madison Park Dr Suite 1b Glen Burnie MD 21061-5627 Ph: (410) 487-6302 |
| NPI Number | 1538548664 |
|---|---|
| Provider Enumeration Date | 05/21/2015 |
| Last Update Date | 05/21/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538548664 | NPI | - | NPPES |
| 402288201 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TP0016X | Psychologist - Prescribing (medical) | (* (Not Available)) | Primary |
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Secondary |
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