MEDICARE: MARRIAN BANGURA

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

General Provider Information

NPI Number	:	1871858878
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARRIAN BANGURA

Provider Business Mailing Address
First Line	:	3575 LAUREL FORT MEADE RD APT 401
Second Line	:
City	:	LAUREL
State	:	MD
Zip	:	20724-2038
Country	:	US
Telephone Number	:	240-586-2064
Fax Number	:

Provider Business Practice Location Address
First Line	:	3575 LAUREL FORT MEADE RD APT 401
Second Line	:
City	:	LAUREL
State	:	MD
Zip	:	20724-2038
Country	:	US
Telephone Number	:	240-586-2064
Fax Number	:

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

Provider Enumeration Date	:	07/06/2012
Last Update Date	:	09/16/2022

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Directions to “ MARRIAN BANGURA ” Practice Location

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