Provider Demographics
NPI:1245788553
Name:ANYAM, DAMARICE
Entity Type:Individual
Prefix:
First Name:DAMARICE
Middle Name:
Last Name:ANYAM
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 1:7777 MAPLE AVE
Mailing Address - Street 2:APT 1101
Mailing Address - City:TAKOMA PARK
Mailing Address - State:MD
Mailing Address - Zip Code:20912-5639
Mailing Address - Country:US
Mailing Address - Phone:301-920-4870
Mailing Address - Fax:
Practice Address - Street 1:7777 MAPLE AVE
Practice Address - Street 2:APT 1101
Practice Address - City:TAKOMA PARK
Practice Address - State:MD
Practice Address - Zip Code:20912-5639
Practice Address - Country:US
Practice Address - Phone:301-920-4870
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-15
Last Update Date:2016-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide