Provider Demographics
NPI:1003632605
Name:SAH, DORIS MUMBO
Entity type:Individual
Prefix:
First Name:DORIS
Middle Name:MUMBO
Last Name:SAH
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 1:6021 BERWYN RD
Mailing Address - Street 2:
Mailing Address - City:BERWYN HEIGHTS
Mailing Address - State:MD
Mailing Address - Zip Code:20740-2639
Mailing Address - Country:US
Mailing Address - Phone:301-851-9250
Mailing Address - Fax:
Practice Address - Street 1:6021 BERWYN RD
Practice Address - Street 2:
Practice Address - City:BERWYN HEIGHTS
Practice Address - State:MD
Practice Address - Zip Code:20740-2639
Practice Address - Country:US
Practice Address - Phone:301-851-9250
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-27
Last Update Date:2024-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide