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General NPI Number Information
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NPI Number | 1821602749
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Entity Type | Individual
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Provider Name | WANDAR BOWIE
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Gender | Female
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Dates
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Enumeration Date | 09/08/2020
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Last Update Date | 09/08/2020
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Provider Practice Location Address
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Address Line | 1315 S ST SE
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City | WASHINGTON
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State | DC
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Zip | 20020-6925
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Country | US
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Telephone | 202-538-1910
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Fax |
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Provider Business Mailing Address
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Address Line | 743 PARK RD NW
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City | WASHINGTON
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State | DC
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Zip | 20010-1517
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Country | US
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Telephone | 202-839-6094
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number |
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License Number State |
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