Provider Demographics
NPI:1821438086
Name:MENSAH, COLINS DJIMELI
Entity Type:Individual
Prefix:MR
First Name:COLINS
Middle Name:DJIMELI
Last Name:MENSAH
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 1:9513 MUIRKIRK RD
Mailing Address - Street 2:APT T1
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20708-2765
Mailing Address - Country:US
Mailing Address - Phone:334-492-1240
Mailing Address - Fax:
Practice Address - Street 1:9513 MUIRKIRK RD
Practice Address - Street 2:APT T1
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20708-2765
Practice Address - Country:US
Practice Address - Phone:334-492-1240
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-02
Last Update Date:2013-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD2538775345163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health