MEDICARE: PATRICK BAH MBAH

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
2	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1679843668
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PATRICK BAH MBAH

Provider Business Mailing Address
First Line	:	1414 9TH ST
Second Line	:
City	:	GLENARDEN
State	:	MD
Zip	:	20706-1632
Country	:	US
Telephone Number	:	202-469-1352
Fax Number	:

Provider Business Practice Location Address
First Line	:	1628 GOOD HOPE RD SE
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20020-4706
Country	:	US
Telephone Number	:	202-889-0900
Fax Number	:

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

Provider Enumeration Date	:	01/06/2012
Last Update Date	:	08/25/2023

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