Provider Demographics
NPI:1457989949
Name:BAH, HAJAFATMATA BINTA (CRNP)
Entity Type:Individual
Prefix:MS
First Name:HAJAFATMATA
Middle Name:BINTA
Last Name:BAH
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6410 ROCKLEDGE DR STE 200
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20817-1830
Mailing Address - Country:US
Mailing Address - Phone:301-897-5301
Mailing Address - Fax:410-367-2059
Practice Address - Street 1:6410 ROCKLEDGE DR STE 200
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20817-1830
Practice Address - Country:US
Practice Address - Phone:301-897-5301
Practice Address - Fax:410-367-2059
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-30
Last Update Date:2023-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR172753207R00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty