Provider Demographics
NPI:1992956775
Name:MOCAM INC
Entity type:Organization
Organization Name:MOCAM INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:EMEKA
Authorized Official - Middle Name:SAM
Authorized Official - Last Name:MOMAH
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:202-291-2005
Mailing Address - Street 1:12320 EUGENES PROSPECT DR
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20720-3373
Mailing Address - Country:US
Mailing Address - Phone:240-235-1907
Mailing Address - Fax:240-235-1908
Practice Address - Street 1:6323 GEORGIA AVE NW STE 206A
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20011-1141
Practice Address - Country:US
Practice Address - Phone:202-291-2005
Practice Address - Fax:202-722-2632
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-10
Last Update Date:2008-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCDO034199261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care