MEDICARE: MAMOUD B 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	374700000X	Technician	MTO138340	MD

General Provider Information

NPI Number	:	1992468565
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MAMOUD B KAMARA

Provider Business Mailing Address
First Line	:	10005 GREENBELT RD APT 203
Second Line	:
City	:	LANHAM
State	:	MD
Zip	:	20706-2229
Country	:	US
Telephone Number	:	646-804-5258
Fax Number	:

Provider Business Practice Location Address
First Line	:	2606 18TH ST SE # THSTSEC
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20020-3259
Country	:	US
Telephone Number	:	706-621-0469
Fax Number	:

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

Provider Enumeration Date	:	10/20/2021
Last Update Date	:	10/23/2021

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Directions to “ MAMOUD B KAMARA ” Practice Location

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