MEDICARE: FATOUMATA H MAIGA M.B.A.

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	251E00000X	Home Health Agency	NSA-0295	DC

General Provider Information

NPI Number	:	1558622472
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FATOUMATA H MAIGA M.B.A.

Provider Business Mailing Address
First Line	:	5730 BLAIR RD NW
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20011-2360
Country	:	US
Telephone Number	:	240-422-6463
Fax Number	:

Provider Business Practice Location Address
First Line	:	5730 BLAIR RD NW
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20011-2360
Country	:	US
Telephone Number	:	240-422-6463
Fax Number	:

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

Provider Enumeration Date	:	06/07/2012
Last Update Date	:	06/07/2012

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