MEDICARE: MYRIANE DJUAZONG SAO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	172V00000X	Community Health Worker
2	171M00000X	Case Manager/Care Coordinator
3	374U00000X	Home Health Aide

General Provider Information

NPI Number	:	1881955235
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MYRIANE DJUAZONG SAO

Provider Business Mailing Address
First Line	:	11700 OLD COLUMBIA PIKE APT 212
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20904-2551
Country	:	US
Telephone Number	:	240-278-1420
Fax Number	:

Provider Business Practice Location Address
First Line	:	11700 OLD COLUMBIA PIKE APT 212
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20904-2551
Country	:	US
Telephone Number	:	240-278-1420
Fax Number	:

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

Provider Enumeration Date	:	06/01/2012
Last Update Date	:	05/04/2026

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