Individual
KOOSHA ADHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4467 OLD BRANCH AVE STE 201, TEMPLE HILLS, MD 20748-1854
(703) 380-3200
Mailing address
4467 OLD BRANCH AVE STE 201, TEMPLE HILLS, MD 20748-1854
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
AC002818
MD
363LA2200X
Adult Health Nurse Practitioner
Primary
AC002818
MD
363LG0600X
Gerontology Nurse Practitioner
AC002818
MD
363LP2300X
Primary Care Nurse Practitioner
AC002818
MD
Other
Enumeration date
04/16/2020
Last updated
04/10/2023
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