MEDICARE: ABIBATU S KAMARA

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	261Q00000X	Clinic/Center

General Provider Information

NPI Number	:	1184592842
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ABIBATU S KAMARA

Provider Business Mailing Address
First Line	:	1715 MILL BRANCH DR
Second Line	:
City	:	LAUREL
State	:	MD
Zip	:	20708-3414
Country	:	US
Telephone Number	:	301-300-6579
Fax Number	:	240-288-1045

Provider Business Practice Location Address
First Line	:	1715 MILL BRANCH DR
Second Line	:
City	:	LAUREL
State	:	MD
Zip	:	20708-3414
Country	:	US
Telephone Number	:	301-300-6579
Fax Number	:	240-288-1045

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

Provider Enumeration Date	:	10/24/2025
Last Update Date	:	10/24/2025

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