Individual
MUSA MARK MOMOH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
12150 ANNAPOLIS RD, SUITE 205, GLENN DALE, MD 20769-9183
(301) 805-1103
(301) 805-1104
Mailing address
12150 ANNAPOLIS RD, SUITE 205, GLENN DALE, MD 20769-9183
(301) 805-1103
(301) 805-1104
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
D52900
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
883910701
—
MD
Enumeration date
11/22/2005
Last updated
09/15/2014
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