Provider Demographics
NPI:1184247090
Name:FUHBIH, MIRABEL LUMNWUH (GNA,MT)
Entity type:Individual
Prefix:
First Name:MIRABEL
Middle Name:LUMNWUH
Last Name:FUHBIH
Suffix:
Gender:F
Credentials:GNA,MT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1836 METZEROTT RD APT 1102
Mailing Address - Street 2:
Mailing Address - City:ADELPHI
Mailing Address - State:MD
Mailing Address - Zip Code:20783-3449
Mailing Address - Country:US
Mailing Address - Phone:240-234-0919
Mailing Address - Fax:
Practice Address - Street 1:5625 NEW HAMPSHIRE AVE NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20011-2335
Practice Address - Country:US
Practice Address - Phone:202-256-1356
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-27
Last Update Date:2020-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDA001577233747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant