Provider Demographics
NPI:1497183826
Name:SAMA ADE, ENGELBERT
Entity Type:Individual
Prefix:
First Name:ENGELBERT
Middle Name:
Last Name:SAMA ADE
Suffix:
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 1:11449 CHERRY HILL RD
Mailing Address - Street 2:APT 203
Mailing Address - City:BELTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20705-3646
Mailing Address - Country:US
Mailing Address - Phone:202-286-1612
Mailing Address - Fax:
Practice Address - Street 1:11449 CHERRY HILL RD
Practice Address - Street 2:APT 203
Practice Address - City:BELTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20705-3646
Practice Address - Country:US
Practice Address - Phone:202-286-1612
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-10-22
Last Update Date:2013-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide