Healthcare Provider Details

I. General information

NPI: 1568327948
Provider Name (Legal Business Name): CARINE FEH GAMOUA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/18/2025
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5825 CHERRYWOOD LN APT 304
GREENBELT MD
20770-4234
US

IV. Provider business mailing address

5825 CHERRYWOOD LN APT 304
GREENBELT MD
20770-4234
US

V. Phone/Fax

Practice location:
  • Phone: 301-860-2945
  • Fax:
Mailing address:
  • Phone: 301-860-2945
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: