Individual
MBAH HENRY MBITEGHAMBO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3215 75TH AVE, HYATTSVILLE, MD 20785-1923
(443) 565-2156
Mailing address
3215 75TH AVE, HYATTSVILLE, MD 20785-1923
(443) 565-2156
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
HHA13614
DC
Other
Enumeration date
04/30/2018
Last updated
04/30/2018
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