Healthcare Provider Details

I. General information

NPI: 1831919695
Provider Name (Legal Business Name): BENSON MULI MUSAU
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: NA NA NA RN

II. Dates (important events)

Enumeration Date: 10/15/2024
Last Update Date: 10/15/2024
Certification Date: 10/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35 K ST NE
WASHINGTON DC
20002-4216
US

IV. Provider business mailing address

233 MOUNTAIN TER
MYERSVILLE MD
21773-8431
US

V. Phone/Fax

Practice location:
  • Phone: 202-839-3500
  • Fax: 202-559-3949
Mailing address:
  • Phone: 240-491-7683
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WA0400X
TaxonomyAddiction (Substance Use Disorder) Registered Nurse
License NumberRN500003489
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: