Organization
JEMIMA A. KANKAM, M.D. P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEMIMA KANKAM M.D. (PRESIDENT)
(301) 604-4830
Entity
Organization
Contact information
Practice address
13639 BALTIMORE AVE, LAUREL, MD 20707-5095
(301) 604-4830
(301) 604-4929
Mailing address
13639 BALTIMORE AVE, LAUREL, MD 20707-5095
(301) 604-4830
(301) 604-4929
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
D030505
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
169301800
—
MD
Enumeration date
10/28/2014
Last updated
10/28/2014
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