Provider Demographics
NPI:1497414825
Name:AHMADU, FUAMBAI S (PHD)
Entity Type:Individual
Prefix:DR
First Name:FUAMBAI
Middle Name:S
Last Name:AHMADU
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9912 EDWARD AVE
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20814-2112
Mailing Address - Country:US
Mailing Address - Phone:202-904-0023
Mailing Address - Fax:
Practice Address - Street 1:9912 EDWARD AVE
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814-2112
Practice Address - Country:US
Practice Address - Phone:202-904-0023
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-13
Last Update Date:2021-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide