Provider Demographics
NPI:1144955501
Name:TAGUIMDJE, AHMED
Entity type:Individual
Prefix:
First Name:AHMED
Middle Name:
Last Name:TAGUIMDJE
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 1:2006 HAMPSHIRE DR
Mailing Address - Street 2:
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20783-2032
Mailing Address - Country:US
Mailing Address - Phone:240-422-0824
Mailing Address - Fax:
Practice Address - Street 1:2006 HAMPSHIRE DR
Practice Address - Street 2:
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20783-2032
Practice Address - Country:US
Practice Address - Phone:240-422-0824
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-20
Last Update Date:2022-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDA00201745374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide