Healthcare Provider Details

I. General information

NPI: 1063341550
Provider Name (Legal Business Name): WILLIAM BAFI
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/19/2026
Last Update Date: 05/19/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4654 NANNIE HELEN BURROUGHS AVE NE
DISTRICT OF COLUMBIA DC
20019
US

IV. Provider business mailing address

2316 NICOL CIR
BOWIE MD
20721-2851
US

V. Phone/Fax

Practice location:
  • Phone: 202-800-6440
  • Fax:
Mailing address:
  • Phone: 240-237-2547
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License NumberMD-10274621054
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: