MEDICARE: QUINTA MANJO MUKOM

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	374U00000X	Home Health Aide		DC

General Provider Information

NPI Number	:	1083572838
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	QUINTA MANJO MUKOM

Provider Business Mailing Address
First Line	:	6911 FOUNTAIN PARK DR
Second Line	:
City	:	GLENN DALE
State	:	MD
Zip	:	20769-9484
Country	:	US
Telephone Number	:	301-850-8402
Fax Number	:

Provider Business Practice Location Address
First Line	:	6911 FOUNTAIN PARK DR
Second Line	:
City	:	GLENN DALE
State	:	MD
Zip	:	20769-9484
Country	:	US
Telephone Number	:	301-850-8402
Fax Number	:

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

Provider Enumeration Date	:	01/12/2026
Last Update Date	:	01/12/2026

Similar Medicare Providers

1265390454 — ALAINGIERECE NKAMENKEEN
Practice Location Address:

6911 FOUNTAIN PARK DR
GLENN DALE, MD
20769-9484

Practice Phone: 240-556-8000
Practice Fax:

1013892074 — DERICK T MUKOM
Practice Location Address:

6911 FOUNTAIN PARK DR
GLENN DALE, MD
20769-9484

Practice Phone: 832-988-8970
Practice Fax:

1689536682 — CARE CREST SUPPORT, INC
Practice Location Address:

6907 FOUNTAIN PARK DR
GLENN DALE, MD
20769-9484

Practice Phone: 301-395-5805
Practice Fax:

1902691272 — PRIVIA MEDICAL GROUP, LLC
Practice Location Address:

12150 ANNAPOLIS RD STE 212
GLENN DALE, MD
20769-9183

Practice Phone: 310-337-2004
Practice Fax:

1134748437 — MONICA NICOLE WILLIAMS
Practice Location Address:

12200 ANNAPOLIS RD STE 315
GLENN DALE, MD
20769-9182

Practice Phone: 301-249-0970
Practice Fax:

1073472593 — FLORENCE MBAH
Practice Location Address:

11300 STRAWBERRY GLENN LN
GLENN DALE, MD
20769-9125

Practice Phone: 240-536-4805
Practice Fax:

Directions to “ QUINTA MANJO MUKOM ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.