Individual
MFONISO D UMOREN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
804 LANDMARK DR STE 118, GLEN BURNIE, MD 21061-4486
(410) 863-4899
Mailing address
804 LANDMARK DR STE 118, GLEN BURNIE, MD 21061-4486
(410) 863-4899
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
71523
TN
207R00000X
Internal Medicine Physician
MD048197
DC
207RG0100X
Gastroenterology Physician
71523
TN
207RG0100X
Gastroenterology Physician
D0098776
MD
207RG0100X
Gastroenterology Physician
Primary
MD048197
DC
Other
Enumeration date
03/29/2017
Last updated
09/29/2025
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