MEDICARE: DERICK MEBUNE

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	171M00000X	Case Manager/Care Coordinator		DC

General Provider Information

NPI Number	:	1023961877
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DERICK MEBUNE

Provider Business Mailing Address
First Line	:	13920 CASTLE BLVD APT 403
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20904-4959
Country	:	US
Telephone Number	:	240-437-2643
Fax Number	:

Provider Business Practice Location Address
First Line	:	13920 CASTLE BLVD APT 403
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20904-4959
Country	:	US
Telephone Number	:	240-437-2643
Fax Number	:

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

Provider Enumeration Date	:	02/19/2026
Last Update Date	:	02/19/2026

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Directions to “ DERICK MEBUNE ” Practice Location

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