MEDICARE: DORIS MUMBO SAH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	376K00000X	Nurse's Aide

General Provider Information

NPI Number	:	1003632605
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DORIS MUMBO SAH

Provider Business Mailing Address
First Line	:	6021 BERWYN RD
Second Line	:
City	:	BERWYN HEIGHTS
State	:	MD
Zip	:	20740-2639
Country	:	US
Telephone Number	:	301-851-9250
Fax Number	:

Provider Business Practice Location Address
First Line	:	6021 BERWYN RD
Second Line	:
City	:	BERWYN HEIGHTS
State	:	MD
Zip	:	20740-2639
Country	:	US
Telephone Number	:	301-851-9250
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/27/2024
Last Update Date	:	11/27/2024

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Directions to “ DORIS MUMBO SAH ” Practice Location

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