Provider Demographics
NPI:1376350249
Name:AFUEH, ALEXANDER ACHAFAC
Entity type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:ACHAFAC
Last Name:AFUEH
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 1:13020 LAUREL BOWIE RD
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20708-2131
Mailing Address - Country:US
Mailing Address - Phone:240-861-1437
Mailing Address - Fax:
Practice Address - Street 1:13020 LAUREL BOWIE RD
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20708-2131
Practice Address - Country:US
Practice Address - Phone:240-861-1437
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-14
Last Update Date:2024-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA200004387374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide