MEDICARE: MR. ANTHONY YINDUI WUSEGHO

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	172V00000X	Community Health Worker
2	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1932917333
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ANTHONY YINDUI WUSEGHO

Provider Business Mailing Address
First Line	:	3993 WARNER AVE APT B5
Second Line	:
City	:	LANDOVER HILLS
State	:	MD
Zip	:	20784-2053
Country	:	US
Telephone Number	:	301-728-7605
Fax Number	:

Provider Business Practice Location Address
First Line	:	3993 WARNER AVE APT B5
Second Line	:
City	:	LANDOVER HILLS
State	:	MD
Zip	:	20784-2053
Country	:	US
Telephone Number	:	301-728-7605
Fax Number	:

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

Provider Enumeration Date	:	12/19/2024
Last Update Date	:	05/11/2026

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