Provider Demographics
NPI:1285272427
Name:TUEKAM, DORIS KAMGA
Entity type:Individual
Prefix:
First Name:DORIS
Middle Name:KAMGA
Last Name:TUEKAM
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 1:9927 FRAGRANT LILIES WAY
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20723-5603
Mailing Address - Country:US
Mailing Address - Phone:202-819-7106
Mailing Address - Fax:
Practice Address - Street 1:9927 FRAGRANT LILIES WAY
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20723-5603
Practice Address - Country:US
Practice Address - Phone:202-819-7106
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-18
Last Update Date:2024-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA14825374U00000X
171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No374U00000XNursing Service Related ProvidersHome Health Aide