MEDICARE: NOELLAR UCHON

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	172V00000X	Community Health Worker	1316676349	DC
2	374U00000X	Home Health Aide	A00200327	MD
3	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1316676349
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NOELLAR UCHON

Provider Business Mailing Address
First Line	:	13184 LARCHDALE RD
Second Line	:
City	:	LAUREL
State	:	MD
Zip	:	20708-1707
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	13184 LARCHDALE RD
Second Line	:
City	:	LAUREL
State	:	MD
Zip	:	20708-1707
Country	:	US
Telephone Number	:	202-940-3605
Fax Number	:

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

Provider Enumeration Date	:	06/06/2022
Last Update Date	:	01/24/2025

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Directions to “ NOELLAR UCHON ” Practice Location

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