Healthcare Provider Details

I. General information

NPI: 1699234427
Provider Name (Legal Business Name): MARIAM S GOMAA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/19/2019
Last Update Date: 05/27/2025
Certification Date: 05/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1133 21ST ST NW STE 200
WASHINGTON DC
20036-3324
US

IV. Provider business mailing address

6201 GREENLEIGH AVE
MIDDLE RIVER MD
21220-2004
US

V. Phone/Fax

Practice location:
  • Phone: 202-331-1740
  • Fax:
Mailing address:
  • Phone: 667-306-7130
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberMD210011596
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: