Provider Demographics
NPI:1437998481
Name:KAMPDOUB KAMDEM, JOVANY
Entity type:Individual
Prefix:
First Name:JOVANY
Middle Name:
Last Name:KAMPDOUB KAMDEM
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 1:10750 VENETIA MILL CIR APT 3A
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20901-1579
Mailing Address - Country:US
Mailing Address - Phone:240-593-3092
Mailing Address - Fax:
Practice Address - Street 1:10750 VENETIA MILL CIR APT 3A
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20901-1579
Practice Address - Country:US
Practice Address - Phone:202-937-8639
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-20
Last Update Date:2025-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker
No171M00000XOther Service ProvidersCase Manager/Care Coordinator