Healthcare Provider Details

I. General information

NPI: 1730897141
Provider Name (Legal Business Name): VICTORIA MEDICAL HOUSE CALLS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/14/2022
Last Update Date: 11/14/2022
Certification Date: 11/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8898 OLD MONTGOMERY RD
COLUMBIA MD
21045-4204
US

IV. Provider business mailing address

8898 OLD MONTGOMERY RD
COLUMBIA MD
21045-4204
US

V. Phone/Fax

Practice location:
  • Phone: 301-646-4891
  • Fax:
Mailing address:
  • Phone: 301-646-4891
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MARINET KAMGA
Title or Position: PRESIDENT
Credential:
Phone: 301-646-4891