Provider Demographics
NPI:1730897141
Name:VICTORIA MEDICAL HOUSE CALLS
Entity type:Organization
Organization Name:VICTORIA MEDICAL HOUSE CALLS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARINET
Authorized Official - Middle Name:
Authorized Official - Last Name:KAMGA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-646-4891
Mailing Address - Street 1:8898 OLD MONTGOMERY RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21045-4204
Mailing Address - Country:US
Mailing Address - Phone:301-646-4891
Mailing Address - Fax:
Practice Address - Street 1:8898 OLD MONTGOMERY RD
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21045-4204
Practice Address - Country:US
Practice Address - Phone:301-646-4891
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-14
Last Update Date:2022-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty