Provider Demographics
NPI:1114507118
Name:NGOEMEUH MORFAW, IVO
Entity Type:Individual
Prefix:
First Name:IVO
Middle Name:
Last Name:NGOEMEUH 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 1:4416 BURKES PROMISE DR
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20720-4697
Mailing Address - Country:US
Mailing Address - Phone:240-486-1437
Mailing Address - Fax:
Practice Address - Street 1:4416 BURKES PROMISE DR
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20720-4697
Practice Address - Country:US
Practice Address - Phone:240-486-1437
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-13
Last Update Date:2021-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide