Provider Demographics
NPI:1558971564
Name:MERCY IJOMA-FAMILY HEALTH CONNECTIONS
Entity Type:Organization
Organization Name:MERCY IJOMA-FAMILY HEALTH CONNECTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:MERCY
Authorized Official - Middle Name:
Authorized Official - Last Name:IJOMA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-280-2407
Mailing Address - Street 1:6281 LOVEKNOT PL
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21045-4512
Mailing Address - Country:US
Mailing Address - Phone:443-280-2407
Mailing Address - Fax:240-713-3512
Practice Address - Street 1:9055 CHEVROLET DR STE 205
Practice Address - Street 2:
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21042-4000
Practice Address - Country:US
Practice Address - Phone:443-280-2407
Practice Address - Fax:240-713-3512
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-04
Last Update Date:2020-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty