Provider Demographics
NPI:1821725318
Name:AMBAW, DANIEL D
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:D
Last Name:AMBAW
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 1:729 SOMERSET PL
Mailing Address - Street 2:
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20783-5001
Mailing Address - Country:US
Mailing Address - Phone:301-732-9154
Mailing Address - Fax:
Practice Address - Street 1:729 SOMERSET PL
Practice Address - Street 2:
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20783-5001
Practice Address - Country:US
Practice Address - Phone:301-732-9154
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-04
Last Update Date:2022-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)