Healthcare Provider Details

I. General information

NPI: 1851210256
Provider Name (Legal Business Name): MISPAR MANKAA SHU
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/11/2026
Last Update Date: 07/11/2026
Certification Date: 07/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13041 SILVER MAPLE CT
BOWIE MD
20715-1933
US

IV. Provider business mailing address

13041 SILVER MAPLE CT
BOWIE MD
20715-1933
US

V. Phone/Fax

Practice location:
  • Phone: 240-543-4198
  • Fax:
Mailing address:
  • Phone: 240-543-4198
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: