Provider Demographics
NPI:1013670710
Name:KAMARA, MARIATU
Entity Type:Individual
Prefix:
First Name:MARIATU
Middle Name:
Last Name:KAMARA
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 COLUMBIA PIKE
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20904-2579
Mailing Address - Country:US
Mailing Address - Phone:631-839-3065
Mailing Address - Fax:
Practice Address - Street 1:11700 OLD COLUMBIA PIKE APT 1213
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20904-2555
Practice Address - Country:US
Practice Address - Phone:631-839-3065
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-19
Last Update Date:2021-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDA00167997376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide