Provider Demographics
NPI:1205267788
Name:MBUH, SAMUEL NDUH
Entity type:Individual
Prefix:
First Name:SAMUEL
Middle Name:NDUH
Last Name:MBUH
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 1:12304 LANHAM SEVERN ROAD
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20720
Mailing Address - Country:US
Mailing Address - Phone:240-271-2630
Mailing Address - Fax:
Practice Address - Street 1:12304 LANHAM SEVERN RD
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20720-4558
Practice Address - Country:US
Practice Address - Phone:240-271-2630
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-09
Last Update Date:2013-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide