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NPI Code Detail

MEDICARE: DR. CARMELLE TABITHA NORICE-TRA MD-PHD

MEDICARE: DR. CARMELLE TABITHA NORICE-TRA MD-PHD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine PhysicianPENDINGMD

General Provider Information

NPI Number : 1104142629
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CARMELLE TABITHA NORICE-TRA MD-PHD
Provider Business Mailing Address
First Line : 10707 VENETIA MILL CIR APT 3B
Second Line :
City : SILVER SPRING
State : MD
Zip : 20901-1598
Country : US
Telephone Number : 301-325-5343
Fax Number :
Provider Business Practice Location Address
First Line : 4 ATLANTIC ST SW
Second Line :
City : WASHINGTON
State : DC
Zip : 20032-2350
Country : US
Telephone Number : 202-407-7747
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/08/2010
Last Update Date : 07/21/2022

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