Provider Demographics
NPI:1124884499
Name:KAMARA, MOHAMED JOSEPH SR
Entity type:Individual
Prefix:
First Name:MOHAMED
Middle Name:JOSEPH
Last Name:KAMARA
Suffix:SR
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 1:8483 GREENBELT RD APT 102
Mailing Address - Street 2:
Mailing Address - City:GREENBELT
Mailing Address - State:MD
Mailing Address - Zip Code:20770-2541
Mailing Address - Country:US
Mailing Address - Phone:202-818-6559
Mailing Address - Fax:
Practice Address - Street 1:2600 BRYAN PL SE # EASTH
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20020-4417
Practice Address - Country:US
Practice Address - Phone:202-813-6559
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-26
Last Update Date:2024-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC7777777777777171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty