Provider Demographics
NPI:1538350335
Name:NIMELY, CONTAH S (MD)
Entity type:Individual
Prefix:DR
First Name:CONTAH
Middle Name:S
Last Name:NIMELY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2404 HUNTERS CHASE CT
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21702-2616
Mailing Address - Country:US
Mailing Address - Phone:610-776-2949
Mailing Address - Fax:
Practice Address - Street 1:24 N WALNUT ST
Practice Address - Street 2:
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21740-4738
Practice Address - Country:US
Practice Address - Phone:301-393-3414
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-06
Last Update Date:2022-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD432376207Q00000X
MDD0066512207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
211841OtherMEDICARE PROVIDER #