Provider Demographics
NPI:1053053132
Name:MBA-JONAS, CHIOMA SADE
Entity Type:Individual
Prefix:
First Name:CHIOMA
Middle Name:SADE
Last Name:MBA-JONAS
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 1:6812 ATWOOD ST APT 2
Mailing Address - Street 2:
Mailing Address - City:DISTRICT HEIGHTS
Mailing Address - State:MD
Mailing Address - Zip Code:20747-1629
Mailing Address - Country:US
Mailing Address - Phone:202-402-9700
Mailing Address - Fax:
Practice Address - Street 1:633 21ST ST NE APT 23
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20002-7446
Practice Address - Country:US
Practice Address - Phone:202-459-3611
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-10
Last Update Date:2022-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant