# MALAMA MEDICAL

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

## Provider details

- **NPI number:** 1659929487
- **Authorized official:** KIMELA JEAN FERGUSON NP (CHIEF EXECUTIVE OFFICER)
- **Authorized official phone:** (443) 802-5130

## Contact information

- **Practice address:** 4604 YORK RD, BALTIMORE, MD 21212-4726
- **Practice address phone:** (443) 802-5130
- **Mailing address:** 34 YORK CT, BALTIMORE, MD 21218-1248
- **Mailing address phone:** (443) 802-5130

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 08/26/2019
- **Last updated:** 02/01/2021