Individual
KWASI A DEBRA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
12200 ANNAPOLIS RD, STE 123, GLENN DALE, MD 20769-9182
(301) 552-9495
(301) 552-9743
Mailing address
12200 ANNAPOLIS RD, STE 123, GLENN DALE, MD 20769-9182
(301) 552-9495
(301) 552-9743
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
MD20163
DC
207VG0400X
Gynecology Physician
Primary
D0040683
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1026004806
CIGNA
MD
01
—
4561470
AETNA
MD
01
—
52507102
CAREFIRST BC BS OF MD
MD
01
—
703633
UNITED HEALTHCARE
MD
01
—
925694
MAMSI
MD
01
—
H9050001
BLUECROSS BLUESHIELD
MD
Enumeration date
08/05/2006
Last updated
04/04/2017
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