Physician Compare National (NPI:1912177288)

HEALTHCARE PROVIDER: IVAN NGANG ZAMA M.D.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1912177288
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	5395874788
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20180131001300
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	ZAMA
	Individual professional last name
Provider First Name	IVAN
	Individual professional first name
Provider Middle Name	NGANG
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	1998
	Individual professional's medical school graduation year
Primary Specialty	INTERNAL MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	HOSPICE/PALLIATIVE CARE
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	HOSPICE/PALLIATIVE CARE
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Organization Legal Name	COMPASSIONATE WELLNESS CENTER LLC
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	5395003305
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	3
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	44 N POTOMAC ST
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 101 AND 102
	Group Practice or individual's line 2 address
City	HAGERSTOWN
	Group Practice or individual's city
State	MD
	Group Practice or individual's state
Zip Code	217403301
	Group Practice or individual's zip code (9 digits when available)
Phone Number	2403471403
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	210051
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	DOCTORS' COMMUNITY HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	210003
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	UNIVERSITY OF MD PRINCE GEORGE'S HOSPITAL CTR
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y