Provider Demographics
NPI:1790529824
Name:FORCHA, MARIE EMEFUET
Entity type:Individual
Prefix:
First Name:MARIE
Middle Name:EMEFUET
Last Name:FORCHA
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 1:10310 FOXLAKE DR
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20721-2607
Mailing Address - Country:US
Mailing Address - Phone:301-473-6493
Mailing Address - Fax:
Practice Address - Street 1:10310 FOXLAKE DR
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20721-2607
Practice Address - Country:US
Practice Address - Phone:301-473-6493
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-24
Last Update Date:2024-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty