Mohamed Ibrahim Koroma

Primary specialty

ContractorTaxonomy code 171W00000X

Practice address

4130 Hunt PL NE
Washington, DC 20019-3565

Phone

(202) 388-4300

Fax

(202) 388-4339

NPI assigned

Mar 8, 2023

Sex

Male

Sole proprietor

No

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Mar 8, 2023.

{
    "created_epoch": "1678233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678233600000",
    "number": "1639879653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4130 HUNT PL NE",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200193565",
            "telephone_number": "202-388-4300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4130 HUNT PL NE",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200193565",
            "telephone_number": "202-388-4300",
            "fax_number": "202-388-4339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOROMA",
        "first_name": "MOHAMED",
        "middle_name": "IBRAHIM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-03-08",
        "last_updated": "2023-03-08",
        "certification_date": "2023-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kezia Koroma
• Margaret Koroma
• Mary Jorfui Koroma
• Mohamed Koroma
• Mohamed Koroma
• Mohamed Maadakin Koroma
• Osainatu Koroma
• Saffie Temple Koroma
• Samuel Bomo Koroma
• Selina Koroma

• All providers in Washington, DC
• Contractor in District of Columbia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.