Individual
AYAH MUMAH TANIFORM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
10600 MELWOOD CHAPEL LN, UPPER MARLBORO, MD 20772-2960
(240) 646-2242
Mailing address
3499 FORT MEADE RD APT 2, LAUREL, MD 20724-2063
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R190176
MD
Other
Enumeration date
09/21/2015
Last updated
01/15/2021
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