Healthcare Provider Details

I. General information

NPI: 1144100033
Provider Name (Legal Business Name): SAMUEL WANDIGA MUNJI
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/03/2025
Last Update Date: 03/26/2026
Certification Date: 03/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5296 MARLBORO PIKE APT 301
CAPITOL HEIGHTS MD
20743-5480
US

IV. Provider business mailing address

3921 MINNESOTA AVE NE
WASHINGTON DC
20019-2662
US

V. Phone/Fax

Practice location:
  • Phone: 404-645-4728
  • Fax:
Mailing address:
  • Phone: 404-645-4728
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License NumberHHA200005552
License Number StateDC
# 2
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: