Provider Demographics
NPI:1275894925
Name:MENUH, JUDE
Entity Type:Individual
Prefix:MR
First Name:JUDE
Middle Name:
Last Name:MENUH
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 1:7401 NEW HAMPSHIRE AVE
Mailing Address - Street 2:#504
Mailing Address - City:TAKOMA PARK
Mailing Address - State:MD
Mailing Address - Zip Code:20912-6945
Mailing Address - Country:US
Mailing Address - Phone:240-481-9200
Mailing Address - Fax:
Practice Address - Street 1:7401 NEW HAMPSHIRE AVE
Practice Address - Street 2:#504
Practice Address - City:TAKOMA PARK
Practice Address - State:MD
Practice Address - Zip Code:20912-6945
Practice Address - Country:US
Practice Address - Phone:240-481-9200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-30
Last Update Date:2012-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD4172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker