Organization
DORA MAMODESENE,MD,PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DORA M MAMODESENE MD (PRESIDENT)
(202) 489-1277
Entity
Organization
Contact information
Practice address
7733 ALASKA AVE NW, NW, WASHINGTON, DC 20012-1421
(202) 882-5300
(301) 989-2276
Mailing address
2057 MAYFLOWER DR, SILVER SPRING, MD 20905-5564
(202) 498-1277
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
0101035678
VA
261QP2300X
Primary Care Clinic/Center
Primary
14222MD
DC
261QP2300X
Primary Care Clinic/Center
D0029649MD
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000148491
MEDICARE
MD
Enumeration date
05/06/2009
Last updated
05/06/2009
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