Healthcare Provider Details

I. General information

NPI: 1831634229
Provider Name (Legal Business Name): HERBERT CUYA HAD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/21/2016
Last Update Date: 12/21/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11604 BUNNELL CT S
POTOMAC MD
20854-3603
US

IV. Provider business mailing address

11604 BUNNELL CT S
POTOMAC MD
20854-3603
US

V. Phone/Fax

Practice location:
  • Phone: 301-299-6714
  • Fax: 301-983-9396
Mailing address:
  • Phone: 301-299-6714
  • Fax: 301-983-9396

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number02778
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: