Provider Demographics
NPI:1912959073
Name:KALOKOH MD, ISMAIL M (MD)
Entity Type:Individual
Prefix:
First Name:ISMAIL
Middle Name:M
Last Name:KALOKOH MD
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 3703
Mailing Address - Street 2:
Mailing Address - City:CAPITOL HEIGHTS
Mailing Address - State:MD
Mailing Address - Zip Code:20791-3703
Mailing Address - Country:US
Mailing Address - Phone:202-397-2200
Mailing Address - Fax:202-397-2688
Practice Address - Street 1:1647 BENNING RD NE
Practice Address - Street 2:SUITE 304
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20002-4569
Practice Address - Country:US
Practice Address - Phone:202-397-2200
Practice Address - Fax:202-397-2688
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-17
Last Update Date:2023-03-17
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Provider Licenses
StateLicense IDTaxonomies
CAC1846162084N0008X
DC21581207R00000X
MDD47927207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No2084N0008XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeuromuscular Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDOK79IM82053502OtherCARE FIRST
DC889545OtherALLIANCE
DCP00089149OtherRAILROAD MEDICARE
DC017134100Medicaid
DC6156OtherBLUE CROSS BLUE SHIELD
DC16957OtherDC CHARTERED HEALTH PLAN
DC1935972OtherUNITED HEALTH CARE
DC67675OtherAMERIGROUP
DC16957OtherDC HEALTH ALLIANCE
MD0243043 00Medicaid
DC2256688OtherAETNA
DC1935972OtherUNITED HEALTH CARE
DCP00089149OtherRAILROAD MEDICARE