OrganizationActive
Ennoble Hc Dmv LLC
NPI 1104492115 · Geriatric Medicine (Family Medicine) Physician · Fulton, MD
Provider details
- NPI number
- 1104492115
- Entity type
- Organization
- Primary specialty
- Geriatric Medicine (Family Medicine) PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Kush Das, Manager(201) 956-8233
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Established profile(62/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
5 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
8115 Maple Lawn Blvd Ste 350
Fulton, MD 20759-2683
Phone: (862) 812-9010
Street-level locationGet directions
Mailing address
39 V St Ne
Washington, DC 20002-1329
Registry dates
- Enumerated
- 2021-06-01
- Last updated
- 2025-11-26
- Certified
- 2025-11-26
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.