Provider Demographics
NPI:1457587461
Name:DUA, REEMA (DPM)
Entity Type:Individual
Prefix:
First Name:REEMA
Middle Name:
Last Name:DUA
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 E GUDE DR STE 200
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-1496
Mailing Address - Country:US
Mailing Address - Phone:301-933-7133
Mailing Address - Fax:301-933-7137
Practice Address - Street 1:11801 ROCKVILLE PIKE STE 105
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-2714
Practice Address - Country:US
Practice Address - Phone:301-881-6222
Practice Address - Fax:301-881-1639
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-04
Last Update Date:2020-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD01588213E00000X
PA25MD00314200213E00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program