Healthcare Provider Details

I. General information

NPI: 1285459420
Provider Name (Legal Business Name): FRANKLINE A MBEKEM ANYI SR.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/21/2024
Last Update Date: 01/16/2025
Certification Date: 01/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

702 JAMES RIDGE RD
BOWIE MD
20721-7282
US

IV. Provider business mailing address

702 JAMES RIDGE RD
BOWIE MD
20721-7282
US

V. Phone/Fax

Practice location:
  • Phone: 240-521-7417
  • Fax:
Mailing address:
  • Phone: 240-521-7417
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: