MEDICARE: ABLAVI GUEDOU

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	376K00000X	Nurse's Aide	AOO196230	MD

General Provider Information

NPI Number	:	1578232963
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ABLAVI GUEDOU

Provider Business Mailing Address
First Line	:	5301 NEW HAMPSHIRE AVE NW APT 212
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20011-6636
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5301 NEW HAMPSHIRE AVE NW APT 212
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20011-6636
Country	:	US
Telephone Number	:	240-595-9754
Fax Number	:

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

Provider Enumeration Date	:	09/08/2021
Last Update Date	:	09/08/2021

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Directions to “ ABLAVI GUEDOU ” Practice Location

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