Provider Demographics
NPI:1861453375
Name:THOMPSON, IFEOMA CECILIA (MD)
Entity Type:Individual
Prefix:
First Name:IFEOMA
Middle Name:CECILIA
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6655 SYKESVILLE ROAD
Mailing Address - Street 2:
Mailing Address - City:SYKESVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21784
Mailing Address - Country:US
Mailing Address - Phone:410-970-7000
Mailing Address - Fax:
Practice Address - Street 1:6655 SYKESVILLE ROAD
Practice Address - Street 2:
Practice Address - City:SYKESVILLE
Practice Address - State:MD
Practice Address - Zip Code:21784
Practice Address - Country:US
Practice Address - Phone:410-970-7000
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD00577122084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
H81841Medicare UPIN