Healthcare Provider Details

I. General information

NPI: 1992211502
Provider Name (Legal Business Name): ISAAC DONKOH NP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/19/2017
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1221 MERCANTILE LN
UPPER MARLBORO MD
20774-5374
US

IV. Provider business mailing address

2866 HEDGEROW PL
BRYANS ROAD MD
20616-7018
US

V. Phone/Fax

Practice location:
  • Phone: 301-618-5500
  • Fax:
Mailing address:
  • Phone: 240-505-9543
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number196961
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: