Provider Demographics
NPI:1780446054
Name:MUSAH, KAMEL MOHAMED
Entity type:Individual
Prefix:MR
First Name:KAMEL
Middle Name:MOHAMED
Last Name:MUSAH
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 1:59 HAMPTON PARK RD
Mailing Address - Street 2:
Mailing Address - City:STAFFORD
Mailing Address - State:VA
Mailing Address - Zip Code:22554-3721
Mailing Address - Country:US
Mailing Address - Phone:703-851-5507
Mailing Address - Fax:
Practice Address - Street 1:59 HAMPTON PARK RD
Practice Address - Street 2:
Practice Address - City:STAFFORD
Practice Address - State:VA
Practice Address - Zip Code:22554-3721
Practice Address - Country:US
Practice Address - Phone:703-851-5507
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-23
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAHCO-0005193374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide