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Individual

DR. MUKEMIL ABDELLA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
12200 ANNAPOLIS RD, SUITE 229, GLENN DALE, MD 20769-9180
(240) 245-4421
(240) 245-4424
Mailing address
12200 ANNAPOLIS RD, SUITE 229, GLENN DALE, MD 20769-9180
(240) 245-4421
(240) 245-4424

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
D0059981
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036237200
DC
01
1376604926
GROUP NPI
DC
01
2115095
ALLIANCE/MAMSI
MD
01
2119347
FIRST HEALTH
MD
01
3237294
AETNA
MD
05
403013300
MD
01
617873
NATIONAL CAPITAL PPO
MD
01
810621843
TAX ID
MD
01
J1200001
DC BC BS
DC
01
KFS6MU
MD BC BS
MD
Enumeration date
08/30/2006
Last updated
05/18/2012
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