Provider Demographics
NPI:1104142629
Name:NORICE-TRA, CARMELLE TABITHA (MD-PHD)
Entity type:Individual
Prefix:DR
First Name:CARMELLE
Middle Name:TABITHA
Last Name:NORICE-TRA
Suffix:
Gender:F
Credentials:MD-PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10707 VENETIA MILL CIR APT 3B
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20901-1598
Mailing Address - Country:US
Mailing Address - Phone:301-325-5343
Mailing Address - Fax:
Practice Address - Street 1:4 ATLANTIC ST SW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20032-2350
Practice Address - Country:US
Practice Address - Phone:202-407-7747
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-08
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDPENDING207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine