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NPI Code Detail

MEDICARE: ISAAC MESUMBE KOGE

MEDICARE:   ISAAC MESUMBE KOGE
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
1251S00000XCommunity/Behavioral Health Agency
2374U00000XHome Health Aide
3171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1942568548
Entity Type Code : Individual
Provider Name (Legal Business Name) : ISAAC MESUMBE KOGE
Provider Business Mailing Address
First Line : 7803 WENDOVER AVE
Second Line :
City : PARKVILLE
State : MD
Zip : 21234-5417
Country : US
Telephone Number : 240-478-0009
Fax Number :
Provider Business Practice Location Address
First Line : 7803 WENDOVER AVE
Second Line :
City : PARKVILLE
State : MD
Zip : 21234-5417
Country : US
Telephone Number : 240-478-0009
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/02/2012
Last Update Date : 07/18/2023

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Directions to “ ISAAC MESUMBE KOGE ” Practice Location

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