Provider Demographics
NPI:1083484299
Name:MORFAW, ROBERT PRINCELY MBENG
Entity Type:Individual
Prefix:
First Name:ROBERT PRINCELY
Middle Name:MBENG
Last Name:MORFAW
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 1:11505 CARRIAGE CROSSING DR
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20772-3166
Mailing Address - Country:US
Mailing Address - Phone:202-744-0136
Mailing Address - Fax:
Practice Address - Street 1:11505 CARRIAGE CROSSING DR
Practice Address - Street 2:
Practice Address - City:UPPER MARLBORO
Practice Address - State:MD
Practice Address - Zip Code:20772-3166
Practice Address - Country:US
Practice Address - Phone:202-744-0136
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-08
Last Update Date:2024-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No374U00000XNursing Service Related ProvidersHome Health Aide