Mukemil Abdella MD LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

D0059981 Issued in MD

Legal business name

MUKEMIL ABDELLA MD LLC

Practice address

12200 Annapolis Rd
Suite 229
Glenn Dale, MD 20769-9180

Phone

(240) 245-4421

Fax

(240) 245-4424

NPI assigned

Dec 13, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mukemil Abdella, MDNPI 1871603381

Title

MD

Phone

(240) 245-4421

Specialties & licenses 1

Addresses

Other identifiers 9

Medicare fee-for-service enrollment

Enrolled in DC

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mukemil Abdella, M.D.

  • Internal Medicine Physician
  • Glenn Dale, MD
  • NPI 1871603381

  DC

  Medicare reassignment Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1263945600000",
    "number": "1376604926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12200 ANNAPOLIS RD",
            "address_2": "SUITE 229",
            "city": "GLENN DALE",
            "state": "MD",
            "postal_code": "207699180",
            "telephone_number": "240-245-4421",
            "fax_number": "240-245-4424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12200 ANNAPOLIS RD",
            "address_2": "SUITE 229",
            "city": "GLENN DALE",
            "state": "MD",
            "postal_code": "207699180",
            "telephone_number": "240-245-4421",
            "fax_number": "240-245-4424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MUKEMIL ABDELLA MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-13",
        "last_updated": "2010-01-20",
        "status": "A",
        "authorized_official_last_name": "ABDELLA",
        "authorized_official_first_name": "MUKEMIL",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "240-245-4421",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D0059981",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI NUMBER",
            "identifier": "1871603381",
            "state": "DC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ALLIANCE",
            "identifier": "2115095",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MD BC BS",
            "identifier": "KFS6MU",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST HEALTH",
            "identifier": "2119347",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036237200",
            "state": "DC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "3237294",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "403013300",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NATIONAL CAPITAL PPO",
            "identifier": "617873",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DC BC BS",
            "identifier": "J120001",
            "state": "DC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Musa Mark Momoh, MD
• Joseph Olisamedua Monye, MD
• Morayo Medical LLC
• Emmanuel Olumuyiwa Moses, PT, DPT, OCS, CCI
• Sylvain Mouzong Aboule
• Derick T Mukom
• Quinta Manjo Mukom
• Multi Health Care Group Inc
• Alambi Walter Muma
• Sergewell Munjei

• Internal Medicine Physician in Glenn Dale, MD
• Providers in Glenn Dale, MD by specialty
• Internal Medicine Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.