Individual
DONNA CONCEPCION
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
11325 PEMBROOKE SQ, SUITE 115, WALDORF, MD 20603-4807
(301) 638-5313
(301) 638-5343
Mailing address
8926 WOODYARD RD, SUITE 701, CLINTON, MD 20735-4220
(301) 856-1682
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
168919ZAKW
MARYLAND MEDICARE
—
01
—
21516
LICENSE #
MD
01
—
46950040
CAREFIRST NCA
—
01
—
64731703
CAREFIRST OF MARYLAND
—
Enumeration date
08/30/2006
Last updated
01/20/2011
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