Individual
DR. EUGIDE KASONGO OTHEPA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
10614 RACETRACK RD UNIT 5, BERLIN, MD 21811-3383
(410) 208-9761
Mailing address
7045 ANTEBELLUM WAY, FREDERICK, MD 21703-7479
(571) 458-9569
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
D0102990
MD
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
03/31/2022
Last updated
07/09/2025
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