Individual
BONJOE TAZIFOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
36 TINDAL SPRINGS CT, MONTGOMERY VILLAGE, MD 20886-4908
(240) 474-7633
Mailing address
36 TINDAL SPRINGS CT, MONTGOMERY VILLAGE, MD 20886-4908
(240) 474-7633
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
374U00000X
Home Health Aide
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
279625494
—
DC
Enumeration date
01/06/2021
Last updated
10/18/2023
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