Provider Demographics
NPI:1154751584
Name:MORGAN STATE UNIVERSITY HEALTH CENTER
Entity type:Organization
Organization Name:MORGAN STATE UNIVERSITY HEALTH CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:NGOZI
Authorized Official - Middle Name:RUTH
Authorized Official - Last Name:AGWUNA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:443-885-3236
Mailing Address - Street 1:1700 E COLD SPRING LN
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21251-0001
Mailing Address - Country:US
Mailing Address - Phone:443-885-3236
Mailing Address - Fax:443-885-8232
Practice Address - Street 1:1700 E COLD SPRING LN
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21251-0001
Practice Address - Country:US
Practice Address - Phone:443-885-3236
Practice Address - Fax:443-885-8232
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MORGAN STATE UNIVERSITY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-11-21
Last Update Date:2013-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1000XAmbulatory Health Care FacilitiesClinic/CenterStudent Health