Provider Demographics
NPI:1144055948
Name:DRAMMEH, OMAR
Entity type:Individual
Prefix:
First Name:OMAR
Middle Name:
Last Name:DRAMMEH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10846 REFUGE CIR
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99515-2452
Mailing Address - Country:US
Mailing Address - Phone:907-748-6875
Mailing Address - Fax:
Practice Address - Street 1:10846 REFUGE CIR
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99515-2452
Practice Address - Country:US
Practice Address - Phone:907-748-6875
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-03
Last Update Date:2024-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK2201754171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator