Organization
ENNOBLE HC DMV III LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KUSHABHADRA DAS (CEO)
(862) 812-9010
Entity
Organization
Contact information
Practice address
962 WAYNE AVE STE 250, SILVER SPRING, MD 20910-4433
(240) 744-0001
Mailing address
2 UNIVERSITY PLZ STE 204, HACKENSACK, NJ 07601-6211
(551) 295-8223
Taxonomy
Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
—
—
Other
Enumeration date
07/29/2025
Last updated
11/03/2025
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