Provider Demographics
NPI:1124383724
Name:MAH, ADAMA HORTENSE
Entity Type:Individual
Prefix:
First Name:ADAMA
Middle Name:HORTENSE
Last Name:MAH
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 1:955 E WEST HWY
Mailing Address - Street 2:35
Mailing Address - City:TAKOMA PARK
Mailing Address - State:MD
Mailing Address - Zip Code:20912-5926
Mailing Address - Country:US
Mailing Address - Phone:202-545-0935
Mailing Address - Fax:202-545-0934
Practice Address - Street 1:955 E WEST HWY
Practice Address - Street 2:35
Practice Address - City:TAKOMA PARK
Practice Address - State:MD
Practice Address - Zip Code:20912-5926
Practice Address - Country:US
Practice Address - Phone:202-545-0935
Practice Address - Fax:202-545-0934
Is Sole Proprietor?:No
Enumeration Date:2012-07-10
Last Update Date:2012-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide