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Individual

MR. COLMAN EJERENWA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
NP

Contact information

Practice address
1922 W PRATT STREET, BALTIMORE, MD 21223
(301) 536-0044
Mailing address
1922 W PRATT STREET, BALTIMORE, MD 21223
(301) 536-0044

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R197772
MD
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
R197772
MD

Other

Enumeration date
12/10/2019
Last updated
06/29/2026
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