Provider Demographics
NPI:1487217956
Name:ADEM, FATUMA A
Entity Type:Individual
Prefix:
First Name:FATUMA
Middle Name:A
Last Name:ADEM
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 1:3910 GEORGIA AVE NW APT 211
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20011-5884
Mailing Address - Country:US
Mailing Address - Phone:202-386-8991
Mailing Address - Fax:
Practice Address - Street 1:3910 GEORGIA AVE NW APT 211
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20011-5884
Practice Address - Country:US
Practice Address - Phone:202-386-8991
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-19
Last Update Date:2019-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA14385374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide