Provider Demographics
NPI:1407116924
Name:WEEMS, MADIA MONIQUE
Entity Type:Individual
Prefix:
First Name:MADIA
Middle Name:MONIQUE
Last Name:WEEMS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1411 3RD ST SW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20024-2907
Mailing Address - Country:US
Mailing Address - Phone:202-820-6878
Mailing Address - Fax:
Practice Address - Street 1:3000 PENNSYLVANIA AVE SE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20020-3718
Practice Address - Country:US
Practice Address - Phone:202-581-0490
Practice Address - Fax:202-581-0496
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-17
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No374U00000XNursing Service Related ProvidersHome Health Aide