Individual
DR. MEMONA TAZAMAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
11901 GEORGIA AVE, WHEATON, MD 20902-2001
(301) 325-3504
Mailing address
11901 GEORGIA AVE, WHEATON, MD 20902-2001
(301) 325-3504
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
D82355
MD
390200000X
Student in an Organized Health Care Education/Training Program
0116024334
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
207OOOOOX
FAMILY MEDICINE
—
01
—
207QOOOOOX
FAMILY MEDICINE
VA
Enumeration date
06/05/2012
Last updated
12/31/2023
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