Provider Demographics
NPI:1023821741
Name:MBOWAH, ELVIS ALEMANJI
Entity type:Individual
Prefix:
First Name:ELVIS
Middle Name:ALEMANJI
Last Name:MBOWAH
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 1:4066 WARNER AVE APT D6
Mailing Address - Street 2:
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20784-1924
Mailing Address - Country:US
Mailing Address - Phone:240-841-5335
Mailing Address - Fax:
Practice Address - Street 1:4066 WARNER AVE APT D6
Practice Address - Street 2:
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20784-1924
Practice Address - Country:US
Practice Address - Phone:240-841-5335
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-28
Last Update Date:2025-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide