Healthcare Provider Details

I. General information

NPI: 1346352903
Provider Name (Legal Business Name): MARCELLA MARIE DONARUMA-KWOH M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6621 FANNIN ST
HOUSTON TX
77030-2303
US

IV. Provider business mailing address

2 E GREENWAY PLZ SUITE 900
HOUSTON TX
77046-0297
US

V. Phone/Fax

Practice location:
  • Phone: 832-824-2271
  • Fax:
Mailing address:
  • Phone: 713-798-1750
  • Fax: 713-798-1144

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberM4039
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: