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NPI Code Detail

MEDICARE: NAHOM ASEGD

MEDICARE: NAHOM ASEGD
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
1171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1477215705
Entity Type Code : Individual
Provider Name (Legal Business Name) : NAHOM ASEGD
Provider Business Mailing Address
First Line : 1024 N 62ND AVE
Second Line :
City : PHOENIX
State : AZ
Zip : 85043-1525
Country : US
Telephone Number : 602-831-8279
Fax Number :
Provider Business Practice Location Address
First Line : 1024 N 62ND AVE
Second Line :
City : PHOENIX
State : AZ
Zip : 85043-1525
Country : US
Telephone Number : 602-831-8279
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/13/2021
Last Update Date : 10/13/2021

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Directions to “ NAHOM ASEGD ” Practice Location

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