Organization
JOSE P NEPOMUCENO MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSE NEPOMUCENO M.D. (PRESIDENT)
(410) 802-1206
Entity
Organization
Contact information
Practice address
7845 OAKWOOD RD, 103, GLEN BURNIE, MD 21061-4256
(410) 768-2048
(410) 768-9171
Mailing address
7845 OAKWOOD RD, 103, GLEN BURNIE, MD 21061-4256
(410) 768-2048
(410) 768-9171
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
D16445
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
012126
—
MD
Enumeration date
01/07/2013
Last updated
01/07/2013
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