Healthcare Provider Details

I. General information

NPI: 1083411136
Provider Name (Legal Business Name): HUMANENESS PROVIDER CARE SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/26/2025
Last Update Date: 04/24/2026
Certification Date: 04/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3450 LAUREL FORT MEADE RD STE 109
LAUREL MD
20724-2040
US

IV. Provider business mailing address

12701 WOODMORE RD
BOWIE MD
20721-4121
US

V. Phone/Fax

Practice location:
  • Phone: 301-344-2023
  • Fax: 833-764-3008
Mailing address:
  • Phone: 301-433-2023
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MUSU KOMEYAN
Title or Position: OWNER/PROVIDER
Credential:
Phone: 301-433-2023