Organization
PARACLETE CARE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IKECHUKWU D MBONU MD (PHYSICIAN)
(410) 740-4411
Entity
Organization
Contact information
Practice address
10801 HICKORY RIDGE RD, SUITE 215, COLUMBIA, MD 21044-3869
(410) 740-4411
(410) 740-4421
Mailing address
8600 VINTAGE EARTH PATH, LAUREL, MD 20723-5879
(301) 483-0615
(240) 280-7118
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
D0059649
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
415713300
—
MD
Enumeration date
03/06/2008
Last updated
05/27/2011
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