Provider Demographics
NPI:1841020070
Name:BAYONGA, OBADIAH BAYA
Entity type:Individual
Prefix:
First Name:OBADIAH
Middle Name:BAYA
Last Name:BAYONGA
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 1:1317 KINGSBURY DR
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20721-2023
Mailing Address - Country:US
Mailing Address - Phone:240-960-9023
Mailing Address - Fax:
Practice Address - Street 1:1317 KINGSBURY DR
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20721-2023
Practice Address - Country:US
Practice Address - Phone:240-960-9023
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-02
Last Update Date:2024-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide