Healthcare Provider Details

I. General information

NPI: 1174105563
Provider Name (Legal Business Name): FATMATA BOCKARIE CONTEH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/25/2021
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10313 GEORGIA AVE STE 202
SILVER SPRING MD
20902-5006
US

IV. Provider business mailing address

5801 POSTAL RD UNIT 81310
CLEVELAND OH
44181-2112
US

V. Phone/Fax

Practice location:
  • Phone: 301-681-9101
  • Fax:
Mailing address:
  • Phone: 301-340-8339
  • Fax: 301-340-9027

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberD0106651
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: