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Organization

ENNOBLE HC DMV LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KUSH DAS (MANAGER)
(201) 956-8233
Entity
Organization

Contact information

Practice address
8115 MAPLE LAWN BLVD STE 350, FULTON, MD 20759-2683
(862) 812-9010
Mailing address
39 V ST NE, WASHINGTON, DC 20002-1329
(862) 812-9010

Taxonomy

Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary

Other

Enumeration date
06/01/2021
Last updated
11/26/2025
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