Provider Demographics
NPI:1043108988
Name:NJUALEM, BENARD NJUALEM
Entity type:Individual
Prefix:
First Name:BENARD
Middle Name:NJUALEM
Last Name:NJUALEM
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12609 DUNKIRK DR
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20772-9352
Mailing Address - Country:US
Mailing Address - Phone:240-593-1139
Mailing Address - Fax:
Practice Address - Street 1:12609 DUNKIRK DR
Practice Address - Street 2:
Practice Address - City:UPPER MARLBORO
Practice Address - State:MD
Practice Address - Zip Code:20772-9352
Practice Address - Country:US
Practice Address - Phone:240-593-1139
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-27
Last Update Date:2025-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide