MEDICARE: MELESE S DARGE

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	HHA14212	DC

General Provider Information

NPI Number	:	1689147829
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELESE S DARGE

Provider Business Mailing Address
First Line	:	1401 FAIRMONT ST NW APT 509
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20009-6931
Country	:	US
Telephone Number	:	571-274-6444
Fax Number	:

Provider Business Practice Location Address
First Line	:	1401 FAIRMONT ST NW APT 509
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20009-6931
Country	:	US
Telephone Number	:	571-274-6444
Fax Number	:

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

Provider Enumeration Date	:	01/10/2019
Last Update Date	:	01/10/2019

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Directions to “ MELESE S DARGE ” Practice Location

Language	Start Address	Practice Location

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