# JOSE P NEPOMUCENO MD PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1457698706
- **Authorized official:** DR. JOSE NEPOMUCENO M.D. (PRESIDENT)
- **Authorized official phone:** (410) 802-1206

## Contact information

- **Practice address:** 7845 OAKWOOD RD, 103, GLEN BURNIE, MD 21061-4256
- **Practice address phone:** (410) 768-2048
- **Practice address fax:** (410) 768-9171
- **Mailing address:** 7845 OAKWOOD RD, 103, GLEN BURNIE, MD 21061-4256
- **Mailing address phone:** (410) 768-2048
- **Mailing address fax:** (410) 768-9171

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | D16445 | MD | Yes |

## Other

- **Enumeration date:** 01/07/2013
- **Last updated:** 01/07/2013

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 012126 | — | MD |