Provider Demographics
NPI:1376310227
Name:BAH, CHICK GEORGE I
Entity Type:Individual
Prefix:
First Name:CHICK
Middle Name:GEORGE
Last Name:BAH
Suffix:I
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 1:11408 SENECA FOREST CIR
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20876-4306
Mailing Address - Country:US
Mailing Address - Phone:301-732-0645
Mailing Address - Fax:
Practice Address - Street 1:11408 SENECA FOREST CIR
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:MD
Practice Address - Zip Code:20876-4306
Practice Address - Country:US
Practice Address - Phone:301-732-0645
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-11
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator