Individual
CLETUS JAM KUKWA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
15003 JORRICK CT, BOWIE, MD 20721-7295
(240) 639-3786
Mailing address
15003 JORRICK CT, BOWIE, MD 20721-7295
(240) 639-3786
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
172V00000X
Community Health Worker
—
—
Other
Enumeration date
06/12/2025
Last updated
06/12/2025
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