MEDICARE: BAHARNESH ABUDULAHIM

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	A134081469447	MD

General Provider Information

NPI Number	:	1538557285
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BAHARNESH ABUDULAHIM

Provider Business Mailing Address
First Line	:	7600 MAPLE AVE
Second Line	:
City	:	TAKOMA PARK
State	:	MD
Zip	:	20912-5571
Country	:	US
Telephone Number	:	240-701-3433
Fax Number	:

Provider Business Practice Location Address
First Line	:	7600 MAPLE AVE
Second Line	:
City	:	TAKOMA PARK
State	:	MD
Zip	:	20912-5571
Country	:	US
Telephone Number	:	240-701-3433
Fax Number	:

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

Provider Enumeration Date	:	01/05/2015
Last Update Date	:	01/05/2015

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Directions to “ BAHARNESH ABUDULAHIM ” Practice Location

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