Provider Demographics
NPI:1326740580
Name:SIUM, BETELEHM H
Entity Type:Individual
Prefix:
First Name:BETELEHM
Middle Name:H
Last Name:SIUM
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 1:1301 14TH ST NW APT 305
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20005-3629
Mailing Address - Country:US
Mailing Address - Phone:202-817-6094
Mailing Address - Fax:
Practice Address - Street 1:1325 UPSHUR ST NW APT 506
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20011-5658
Practice Address - Country:US
Practice Address - Phone:202-604-4091
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-21
Last Update Date:2023-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide