MEDICARE: DR. TREMIKAE R OWENS M.D.

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
1	207Q00000X	Family Medicine Physician	E3858	AR

General Provider Information

NPI Number	:	1104800473
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TREMIKAE R OWENS M.D.

Provider Business Mailing Address
First Line	:	2848 CHANCELLORS WAY NE
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20017-1415
Country	:	US
Telephone Number	:	501-960-5587
Fax Number	:

Provider Business Practice Location Address
First Line	:	2848 CHANCELLORS WAY NE
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20017-1415
Country	:	US
Telephone Number	:	501-960-5587
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/01/2005
Last Update Date	:	12/16/2024

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