Provider Demographics
NPI:1770812315
Name:MED CHAMPIONS
Entity type:Organization
Organization Name:MED CHAMPIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT AND CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:FEMI
Authorized Official - Middle Name:K
Authorized Official - Last Name:OYEDELE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-437-4630
Mailing Address - Street 1:1229 WINDMILL LN
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20905-6055
Mailing Address - Country:US
Mailing Address - Phone:301-437-4630
Mailing Address - Fax:301-438-3374
Practice Address - Street 1:230 RHODE ISLAND AVE NE APT 304
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20002-6836
Practice Address - Country:US
Practice Address - Phone:301-427-4630
Practice Address - Fax:301-438-3374
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-10
Last Update Date:2009-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental DisabilitiesGroup - Multi-Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No103TR0400XBehavioral Health & Social Service ProvidersPsychologistRehabilitationGroup - Multi-Specialty