Provider Demographics
NPI:1851909840
Name:BAH MUYA, NADEGE MANYI
Entity Type:Individual
Prefix:
First Name:NADEGE MANYI
Middle Name:
Last Name:BAH MUYA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10826 SUGAR MAPLE TER
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20774-1322
Mailing Address - Country:US
Mailing Address - Phone:240-579-1145
Mailing Address - Fax:
Practice Address - Street 1:10826 SUGAR MAPLE TER
Practice Address - Street 2:
Practice Address - City:UPPER MARLBORO
Practice Address - State:MD
Practice Address - Zip Code:20774-1322
Practice Address - Country:US
Practice Address - Phone:240-579-1145
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-16
Last Update Date:2020-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide