MEDICARE: MARIE CHRISTINE NKODO MD

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	207V00000X	Obstetrics & Gynecology Physician	D0039174	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1245395821
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIE CHRISTINE NKODO MD

Provider Business Mailing Address
First Line	:	3923 ARBOR CREST WAY
Second Line	:
City	:	ROCKVILLE
State	:	MD
Zip	:	20853-3286
Country	:	US
Telephone Number	:	301-924-4576
Fax Number	:

Provider Business Practice Location Address
First Line	:	7582 ANNAPOLIS RD
Second Line	:
City	:	HYATTSVILLE
State	:	MD
Zip	:	20784-1744
Country	:	US
Telephone Number	:	301-618-1550
Fax Number	:	301-429-1873

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

Provider Enumeration Date	:	12/26/2006
Last Update Date	:	07/08/2007

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