Provider Demographics
NPI:1437609864
Name:DOUNTIO MELI, EDWIGE
Entity Type:Individual
Prefix:
First Name:EDWIGE
Middle Name:
Last Name:DOUNTIO MELI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:EDWIGE
Other - Middle Name:
Other - Last Name:DOUNTIO MELI EPSE TINWA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3405 DODGE PARK RD APT 101
Mailing Address - Street 2:
Mailing Address - City:LANDOVER
Mailing Address - State:MD
Mailing Address - Zip Code:20785-2013
Mailing Address - Country:US
Mailing Address - Phone:240-486-2042
Mailing Address - Fax:
Practice Address - Street 1:3405 DODGE PARK RD APT 101
Practice Address - Street 2:
Practice Address - City:LANDOVER
Practice Address - State:MD
Practice Address - Zip Code:20785-2013
Practice Address - Country:US
Practice Address - Phone:240-486-2042
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-10
Last Update Date:2016-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA11824374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide