Provider Demographics
NPI:1447749536
Name:DOOKWAH, DARREL
Entity Type:Individual
Prefix:
First Name:DARREL
Middle Name:
Last Name:DOOKWAH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5307 STINGRAY CT
Mailing Address - Street 2:
Mailing Address - City:WALDORF
Mailing Address - State:MD
Mailing Address - Zip Code:20603-4262
Mailing Address - Country:US
Mailing Address - Phone:202-372-5868
Mailing Address - Fax:
Practice Address - Street 1:5307 STINGRAY CT
Practice Address - Street 2:
Practice Address - City:WALDORF
Practice Address - State:MD
Practice Address - Zip Code:20603-4262
Practice Address - Country:US
Practice Address - Phone:202-372-5868
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-04
Last Update Date:2018-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant