IndividualActive
Momodu Jack, M.D.
NPI 1164521019 · Gastroenterology Physician · Washington, DC
Provider details
- NPI number
- 1164521019
- Entity type
- Individual
- Primary specialty
- Gastroenterology PhysicianAllopathic & Osteopathic Physicians
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- Yes
- License
- D0044035 (MD)
Practice location
2139 Georgia Ave Nw
Suite 3a
Washington, DC 20001-3035
Phone: (202) 865-7981
Fax: (301) 621-5313
Mailing address
Po Box 2325
Columbia, MD 21045-1325
Registry dates
- Enumerated
- 2006-09-21
- Last updated
- 2020-11-06
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.