Provider Demographics
NPI:1497592463
Name:ERIC, NEBA MULAAH
Entity type:Individual
Prefix:
First Name:NEBA
Middle Name:MULAAH
Last Name:ERIC
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 1:9703 SUMMIT CIR APT 3B
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:MD
Mailing Address - Zip Code:20774-3729
Mailing Address - Country:US
Mailing Address - Phone:301-825-1989
Mailing Address - Fax:
Practice Address - Street 1:9703 SUMMIT CIR APT 3B
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:MD
Practice Address - Zip Code:20774-3729
Practice Address - Country:US
Practice Address - Phone:301-825-1989
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-09
Last Update Date:2024-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator