Provider Demographics
NPI:1558622472
Name:MAIGA, FATOUMATA H (MBA)
Entity Type:Individual
Prefix:
First Name:FATOUMATA
Middle Name:H
Last Name:MAIGA
Suffix:
Gender:F
Credentials:MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5730 BLAIR RD NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20011-2360
Mailing Address - Country:US
Mailing Address - Phone:240-422-6463
Mailing Address - Fax:
Practice Address - Street 1:5730 BLAIR RD NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20011-2360
Practice Address - Country:US
Practice Address - Phone:240-422-6463
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-07
Last Update Date:2012-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCNSA-0295251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health