Provider Demographics
NPI:1851848279
Name:KAMARA, ABU BAKARR (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:DR
First Name:ABU
Middle Name:BAKARR
Last Name:KAMARA
Suffix:
Gender:M
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5203 WILEY ST
Mailing Address - Street 2:
Mailing Address - City:RIVERDALE
Mailing Address - State:MD
Mailing Address - Zip Code:20737-3042
Mailing Address - Country:US
Mailing Address - Phone:301-996-2833
Mailing Address - Fax:
Practice Address - Street 1:631 CHERRY HILL RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21225-1228
Practice Address - Country:US
Practice Address - Phone:410-354-2000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-01
Last Update Date:2016-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR195854363LF0000X
DCRN1021119363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily