Moa Psychiatric Practice Llc | |
28 Flint Dr North East MD 21901-3746 | |
(240) 997-0287 | |
Not Available |
Full Name | Moa Psychiatric Practice Llc |
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Speciality | Clinic/Center |
Location | 28 Flint Dr, North East, Maryland |
Authorized Official Name and Position | Olumide Mesioye (PRESIDENT) |
Authorized Official Contact | 2409970287 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Moa Psychiatric Practice Llc 28 Flint Dr North East MD 21901-3746 Ph: (240) 997-0287 | Moa Psychiatric Practice Llc 28 Flint Dr North East MD 21901-3746 Ph: (240) 997-0287 |
NPI Number | 1295507127 |
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Provider Enumeration Date | 10/24/2023 |
Last Update Date | 10/24/2023 |
Certification Date | 10/24/2023 |
Medicare PECOS PAC ID | 2062869332 |
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Medicare Enrollment ID | O20231108000408 |
Identifier | Type | State | Issuer |
---|---|---|---|
1295507127 | NPI | - | NPPES |
Provider Name | Olumide Mesioye |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1225741697 PECOS PAC ID: 3971950247 Enrollment ID: I20231108000482 |
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