Provider Demographics
NPI:1437414455
Name:TAKEM, ALBERT ENOW (MD)
Entity Type:Individual
Prefix:
First Name:ALBERT
Middle Name:ENOW
Last Name:TAKEM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:ALBERT
Other - Middle Name:ENOW
Other - Last Name:TAKEM
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:14314 OLD MARLBORO PIKE
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20772-2840
Mailing Address - Country:US
Mailing Address - Phone:301-627-3500
Mailing Address - Fax:540-853-0931
Practice Address - Street 1:14314 OLD MARLBORO PIKE
Practice Address - Street 2:
Practice Address - City:UPPER MARLBORO
Practice Address - State:MD
Practice Address - Zip Code:20772-2840
Practice Address - Country:US
Practice Address - Phone:301-627-3500
Practice Address - Fax:833-559-0865
Is Sole Proprietor?:No
Enumeration Date:2012-07-05
Last Update Date:2021-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35099563207R00000X
DCMD043883207R00000X
MDD77221207R00000X
VA0101252064208M00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist