Provider Demographics
NPI:1477251114
Name:KAROGI, MOSES MAINA (PMHNP)
Entity Type:Individual
Prefix:
First Name:MOSES
Middle Name:MAINA
Last Name:KAROGI
Suffix:
Gender:M
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 WYNDHURST AVE STE 100J
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21210-2489
Mailing Address - Country:US
Mailing Address - Phone:443-500-7439
Mailing Address - Fax:
Practice Address - Street 1:600 WYNDHURST AVE STE 100J
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21210-2489
Practice Address - Country:US
Practice Address - Phone:410-801-9885
Practice Address - Fax:410-779-3799
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-22
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR223469363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health