Most Relevant Information
Provider Data
| NPI Number: | 1003650821 |
| Provider Name: | MARY UCHE KEMAKOLAM |
| Entity Type: | Individual |
| Taxonomy Code: | 363LP0808X |
| Specialty: | Nurse Practitioner |
| License Number: | R136375 |
Most Important Dates
| Enumeration Date: | 06/25/2024 |
| Last Updated: | 06/25/2024 |
Provider Practice Location
1100 ALABAMA AVE SE
WASHINGTON
DC
200324542
Practice Location Phone/Fax
| Phone: | 2022995100 |
| Fax: |
Provider Mailing Location
7150 CONTEE RD
LAUREL
MD
207079527
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |