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Individual

FATMATA BANGURAH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
5601 PAYNES ENDEAVOR DR, BOWIE, MD 20720-3380
(202) 567-6521
Mailing address
5601 PAYNES ENDEAVOR DR, BOWIE, MD 20720-3380
(124) 048-7829

Taxonomy

Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
A00053791
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
556
MD
Enumeration date
08/10/2021
Last updated
08/16/2021
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