Organization
GAMBRILLS SISTERS HEALTH CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FATU KOROMA CRNP (OWNER)
(240) 437-2705
Entity
Organization
Contact information
Practice address
106 CALUMET CT, GAMBRILLS, MD 21054-1060
(240) 437-2705
Mailing address
106 CALUMET CT, GAMBRILLS, MD 21054-1060
(240) 437-2705
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R187334
LICENSE
MD
Enumeration date
04/18/2022
Last updated
07/18/2024
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