Provider Demographics
NPI:1629338520
Name:AKWAR, MARY ENDAM
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:ENDAM
Last Name:AKWAR
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 1:11700 OLD OLUMBIA PIKE
Mailing Address - Street 2:APT.917
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20904
Mailing Address - Country:US
Mailing Address - Phone:202-403-1413
Mailing Address - Fax:
Practice Address - Street 1:11700 OLD COLUMBIA PIKE APT 917
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20904-2554
Practice Address - Country:US
Practice Address - Phone:240-476-0154
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-24
Last Update Date:2012-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHOME HEALTH AIDE374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide