Provider Demographics
NPI:1750621389
Name:KAMDOM-TCHOKOTHE, EDWIGE
Entity type:Individual
Prefix:
First Name:EDWIGE
Middle Name:
Last Name:KAMDOM-TCHOKOTHE
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 1:14225 PEAR TREE LN
Mailing Address - Street 2:APT #22
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20906-2526
Mailing Address - Country:US
Mailing Address - Phone:240-481-9810
Mailing Address - Fax:
Practice Address - Street 1:14225 PEAR TREE LN
Practice Address - Street 2:APT #22
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20906-2526
Practice Address - Country:US
Practice Address - Phone:240-481-9810
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-19
Last Update Date:2013-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program