Provider Demographics
NPI:1144939182
Name:MEDOUGOU, BAYAMINA HOMEBEY
Entity type:Individual
Prefix:MR
First Name:BAYAMINA
Middle Name:HOMEBEY
Last Name:MEDOUGOU
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 1:11375 LIPPELMAN RD APT 305
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45246-4021
Mailing Address - Country:US
Mailing Address - Phone:513-616-2131
Mailing Address - Fax:
Practice Address - Street 1:11375 LIPPELMAN RD APT 305
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45246-4021
Practice Address - Country:US
Practice Address - Phone:513-616-2131
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-17
Last Update Date:2022-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health