# MISO MEDICAL CENTER

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

## Provider details

- **NPI number:** 1871252767
- **Authorized official:** MS. IFEOMA C ONYIA (CEO)
- **Authorized official phone:** (240) 918-3829

## Contact information

- **Practice address:** 14440 CHERRY LANE CT STE 218, LAUREL, MD 20707-4946
- **Practice address phone:** (240) 918-3829
- **Practice address fax:** (301) 567-7399
- **Mailing address:** 14440 CHERRY LANE CT STE 218, LAUREL, MD 20707-4946
- **Mailing address phone:** (240) 918-3829
- **Mailing address fax:** (301) 567-7399

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | NULL | Yes |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | — | Yes |

## Other

- **Enumeration date:** 12/08/2021
- **Last updated:** 12/08/2021