Healthcare Provider Details

I. General information

NPI: 1750195103
Provider Name (Legal Business Name): BELMOND AJAH TAMBA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/05/2025
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6827 RED TOP RD
TAKOMA PARK MD
20912-5980
US

IV. Provider business mailing address

6827 RED TOP RD
TAKOMA PARK MD
20912-5980
US

V. Phone/Fax

Practice location:
  • Phone: 240-788-0891
  • Fax:
Mailing address:
  • Phone: 240-788-0891
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number200006498
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: