Provider Demographics
NPI:1700354552
Name:MILDRED WAHWING, BINDA
Entity Type:Individual
Prefix:
First Name:BINDA
Middle Name:
Last Name:MILDRED WAHWING
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10302 SILKWOOD CT
Mailing Address - Street 2:
Mailing Address - City:SPRINGDALE
Mailing Address - State:MD
Mailing Address - Zip Code:20774-2591
Mailing Address - Country:US
Mailing Address - Phone:240-615-4402
Mailing Address - Fax:
Practice Address - Street 1:10302 SILKWOOD CT
Practice Address - Street 2:
Practice Address - City:SPRINGDALE
Practice Address - State:MD
Practice Address - Zip Code:20774-2591
Practice Address - Country:US
Practice Address - Phone:240-615-4402
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-09
Last Update Date:2018-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA13796374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide