Provider Demographics
NPI:1750195103
Name:TAMBA, BELMOND AJAH
Entity type:Individual
Prefix:
First Name:BELMOND
Middle Name:AJAH
Last Name:TAMBA
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 1:6827 RED TOP RD
Mailing Address - Street 2:
Mailing Address - City:TAKOMA PARK
Mailing Address - State:MD
Mailing Address - Zip Code:20912-5980
Mailing Address - Country:US
Mailing Address - Phone:240-788-0891
Mailing Address - Fax:
Practice Address - Street 1:6827 RED TOP RD
Practice Address - Street 2:
Practice Address - City:TAKOMA PARK
Practice Address - State:MD
Practice Address - Zip Code:20912-5980
Practice Address - Country:US
Practice Address - Phone:240-788-0891
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-05
Last Update Date:2025-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator