Provider Demographics
NPI:1184401242
Name:SHEIKH-ADAM, KOWTHAR A (CNM)
Entity type:Individual
Prefix:
First Name:KOWTHAR
Middle Name:A
Last Name:SHEIKH-ADAM
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8110 MAPLE LAWN BLVD STE 235
Mailing Address - Street 2:
Mailing Address - City:FULTON
Mailing Address - State:MD
Mailing Address - Zip Code:20759-2694
Mailing Address - Country:US
Mailing Address - Phone:301-340-8339
Mailing Address - Fax:
Practice Address - Street 1:19450 DEERFIELD AVE
Practice Address - Street 2:STE 460
Practice Address - City:LEESBURG
Practice Address - State:VA
Practice Address - Zip Code:20176-6840
Practice Address - Country:US
Practice Address - Phone:571-707-8522
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-12
Last Update Date:2023-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024188283367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife