Individual
MBAH CHARLES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3705 CLAYTON DR, BOWIE, MD 20721
(202) 264-9243
Mailing address
13409 BIRKHALL DR, LAUREL, MD 20707-3101
(202) 264-9243
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
DC
171M00000X
Case Manager/Care Coordinator
—
MD
374U00000X
Home Health Aide
Primary
HHA13896
DC
Other
Enumeration date
08/10/2018
Last updated
08/09/2024
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