Provider Demographics
NPI:1891020442
Name:DYNAMIC HEALTH CARE LLC
Entity Type:Organization
Organization Name:DYNAMIC HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:OLUKAYODE
Authorized Official - Last Name:AKINNUOYE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-864-8874
Mailing Address - Street 1:516 S CONKLING ST
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21224-4201
Mailing Address - Country:US
Mailing Address - Phone:410-864-8874
Mailing Address - Fax:410-864-8051
Practice Address - Street 1:516 S CONKLING ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21224-4201
Practice Address - Country:US
Practice Address - Phone:410-864-8874
Practice Address - Fax:410-864-8051
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-14
Last Update Date:2009-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty