MEDICARE: CLAUDINE ANGIEK TEBOH

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	374U00000X	Home Health Aide	HHA14275	DC

General Provider Information

NPI Number	:	1518423821
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CLAUDINE ANGIEK TEBOH

Provider Business Mailing Address
First Line	:	6809 JADE CT
Second Line	:
City	:	CAPITOL HEIGHTS
State	:	MD
Zip	:	20743-1862
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6809 JADE CT
Second Line	:
City	:	CAPITOL HEIGHTS
State	:	MD
Zip	:	20743-1862
Country	:	US
Telephone Number	:	202-560-4979
Fax Number	:

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

Provider Enumeration Date	:	02/12/2019
Last Update Date	:	02/12/2019

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Directions to “ CLAUDINE ANGIEK TEBOH ” Practice Location

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