Healthcare Provider Details

I. General information

NPI: 1992166862
Provider Name (Legal Business Name): NAMARIG SOUMIT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/18/2016
Last Update Date: 04/01/2025
Certification Date: 04/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6401 AMERICA BLVD STE 200
HYATTSVILLE MD
20782-2357
US

IV. Provider business mailing address

10980 GRANTCHESTER WAY
COLUMBIA MD
21044-6097
US

V. Phone/Fax

Practice location:
  • Phone: 855-910-3278
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberDO210012338
License Number StateDC
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberH0097387
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number0102208366
License Number StateVA
# 4
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOS019914
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: