Healthcare Provider Details

I. General information

NPI: 1295564888
Provider Name (Legal Business Name): JULIUS AFANWI SHUNEH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/31/2024
Last Update Date: 08/19/2025
Certification Date: 08/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1341 HAMPSHIRE DR
FREDERICK MD
21702-1185
US

IV. Provider business mailing address

1341 HAMPSHIRE DR
FREDERICK MD
21702-1185
US

V. Phone/Fax

Practice location:
  • Phone: 240-334-8498
  • Fax:
Mailing address:
  • Phone: 240-334-8498
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License NumberA00219213
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License NumberA00219213
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License NumberA00219213
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: