Provider Demographics
NPI:1245922822
Name:NEBA, FRITZ JUNIOR FOBE
Entity type:Individual
Prefix:
First Name:FRITZ JUNIOR FOBE
Middle Name:
Last Name:NEBA
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 1:8187 SCENIC MEADOW DR APT B204
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20724-6085
Mailing Address - Country:US
Mailing Address - Phone:240-495-4566
Mailing Address - Fax:
Practice Address - Street 1:8187 SCENIC MEADOW DR APT B204
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20724-6085
Practice Address - Country:US
Practice Address - Phone:240-495-4566
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-23
Last Update Date:2023-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA14179374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide