MEDICARE: MARIE EMERENCE AZAH NGUH

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	:	1992526685
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIE EMERENCE AZAH NGUH

Provider Business Mailing Address
First Line	:	9710 DUBARRY ST
Second Line	:
City	:	GLENN DALE
State	:	MD
Zip	:	20769-9285
Country	:	US
Telephone Number	:	240-940-7139
Fax Number	:

Provider Business Practice Location Address
First Line	:	9710 DUBARRY ST
Second Line	:
City	:	GLENN DALE
State	:	MD
Zip	:	20769-9285
Country	:	US
Telephone Number	:	240-940-7139
Fax Number	:

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

Provider Enumeration Date	:	10/24/2024
Last Update Date	:	10/24/2024

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