Individual
ASFAW NIGUSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
7600 MAPLE AVE, TAKOMA PARK, MD 20912-5571
(240) 478-0075
Mailing address
7600 MAPLE AVE, TAKOMA PARK, MD 20912-5571
(240) 478-0075
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
CNA20202033
—
MD
Enumeration date
10/13/2020
Last updated
10/13/2020
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