Provider Demographics
NPI:1861049579
Name:BAH, MARIAMA MARANDA
Entity type:Individual
Prefix:
First Name:MARIAMA
Middle Name:MARANDA
Last Name:BAH
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 1:4807 DAISEY CREEK TER
Mailing Address - Street 2:
Mailing Address - City:BELTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20705-1139
Mailing Address - Country:US
Mailing Address - Phone:301-605-3799
Mailing Address - Fax:
Practice Address - Street 1:4807 DAISEY CREEK TER
Practice Address - Street 2:
Practice Address - City:BELTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20705-1139
Practice Address - Country:US
Practice Address - Phone:240-899-0851
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-19
Last Update Date:2019-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDMT0095085376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide