MEDICARE: COMFORT NGWECHI MBONEFOR

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	172V00000X	Community Health Worker		DC
2	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1528772779
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	COMFORT NGWECHI MBONEFOR

Provider Business Mailing Address
First Line	:	9632 GREENEL RD
Second Line	:
City	:	DAMASCUS
State	:	MD
Zip	:	20872-2396
Country	:	US
Telephone Number	:	804-888-5383
Fax Number	:

Provider Business Practice Location Address
First Line	:	1418 GOOD HOPE RD SE
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20020-5615
Country	:	US
Telephone Number	:	202-796-5000
Fax Number	:

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

Provider Enumeration Date	:	01/12/2023
Last Update Date	:	06/22/2026

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Directions to “ COMFORT NGWECHI MBONEFOR ” Practice Location

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