Healthcare Provider Details

I. General information

NPI: 1083551550
Provider Name (Legal Business Name): ISAIAH MUKARA MBAH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2026
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1705 E WEST HWY APT 314
SILVER SPRING MD
20910-3061
US

IV. Provider business mailing address

1705 E WEST HWY APT 314
SILVER SPRING MD
20910-3061
US

V. Phone/Fax

Practice location:
  • Phone: 240-660-8281
  • Fax:
Mailing address:
  • Phone: 240-660-8281
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: