Provider Demographics
NPI:1326418989
Name:MBELE, COMFORT
Entity Type:Individual
Prefix:
First Name:COMFORT
Middle Name:
Last Name:MBELE
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 1:1016 RUATAN ST
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20903-3215
Mailing Address - Country:US
Mailing Address - Phone:301-633-8095
Mailing Address - Fax:
Practice Address - Street 1:1016 RUATAN ST
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20903-3215
Practice Address - Country:US
Practice Address - Phone:301-633-8095
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-25
Last Update Date:2015-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide