Provider Demographics
NPI:1417834938
Name:TERRY KING, SHAMIKA
Entity type:Individual
Prefix:
First Name:SHAMIKA
Middle Name:
Last Name:TERRY KING
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12615 GLADYS RETREAT CIR
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20720-3334
Mailing Address - Country:US
Mailing Address - Phone:202-497-9907
Mailing Address - Fax:
Practice Address - Street 1:570 NEWCOMB ST SE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20032-2552
Practice Address - Country:US
Practice Address - Phone:202-497-9907
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-18
Last Update Date:2025-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant