MEDICARE: FADUMO HUSSEIN ANSHUR

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1255144614
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FADUMO HUSSEIN ANSHUR

Provider Business Mailing Address
First Line	:	3713 S GEORGE MASON DR
Second Line	:
City	:	FALLS CHURCH
State	:	VA
Zip	:	22041-3761
Country	:	US
Telephone Number	:	571-999-5145
Fax Number	:

Provider Business Practice Location Address
First Line	:	5622 COLUMBIA PIKE STE 307C
Second Line	:
City	:	FALLS CHURCH
State	:	VA
Zip	:	22041-2718
Country	:	US
Telephone Number	:	571-999-5145
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/29/2025
Last Update Date	:	01/29/2025

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