Provider Demographics
NPI:1649928367
Name:KAMARA, MOHAMED A
Entity type:Individual
Prefix:
First Name:MOHAMED
Middle Name:A
Last Name:KAMARA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6025 67TH AVE APT 6
Mailing Address - Street 2:
Mailing Address - City:RIVERDALE
Mailing Address - State:MD
Mailing Address - Zip Code:20737-1767
Mailing Address - Country:US
Mailing Address - Phone:240-486-2396
Mailing Address - Fax:
Practice Address - Street 1:6025 67TH AVE APT 6
Practice Address - Street 2:
Practice Address - City:RIVERDALE
Practice Address - State:MD
Practice Address - Zip Code:20737-1767
Practice Address - Country:US
Practice Address - Phone:240-486-2396
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-11
Last Update Date:2022-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCNA0000803876376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide