Provider Demographics
NPI:1043943947
Name:FADAHUNSI, MISKIAT
Entity Type:Individual
Prefix:
First Name:MISKIAT
Middle Name:
Last Name:FADAHUNSI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7845 RIVERDALE RD APT 103
Mailing Address - Street 2:
Mailing Address - City:NEW CARROLLTON
Mailing Address - State:MD
Mailing Address - Zip Code:20784-4009
Mailing Address - Country:US
Mailing Address - Phone:202-878-3707
Mailing Address - Fax:
Practice Address - Street 1:7845 RIVERDALE RD APT 103
Practice Address - Street 2:
Practice Address - City:NEW CARROLLTON
Practice Address - State:MD
Practice Address - Zip Code:20784-4009
Practice Address - Country:US
Practice Address - Phone:202-878-3707
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-07
Last Update Date:2022-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide