Defoe, David Imamu

Defoe, David Imamu is an sole proprietor health care provider with primary practice located at 14502 Greenview Dr Ste 202 , Laurel MD 20708-3287. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Professional. Behavioral Health & Social Service Providers / Mental Health is his primary health care specialty. Defoe, David Imamu can be contacted via phone (301) 821-0049.

Contact Information

Primary practice address
14502 Greenview Dr Ste 202 Laurel MD 20708-3287
Phone: (301) 821-0049
Fax: (240) 513-4122
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X LC6147 Maryland
Behavioral Health & Social Service Providers / Professional 101YP2500X LC6147 Maryland

Profile Details

NPI number 1124452123
LBN Legal business name Defoe, David Imamu
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 26th, 2013
Last updated Jun 13th, 2022 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1124452123 NPPES
Maryland MEDICAID 873928

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