Provider Demographics
NPI:1366703431
Name:TUMASANG, MICHAEL
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:TUMASANG
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:MICHAEL
Other - Middle Name:
Other - Last Name:TUMASANG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:HOME HEALTH AIDE
Mailing Address - Street 1:1771 ELTON RD
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20903-1757
Mailing Address - Country:US
Mailing Address - Phone:240-355-3549
Mailing Address - Fax:
Practice Address - Street 1:1771 ELTON RD
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20903-1757
Practice Address - Country:US
Practice Address - Phone:240-355-3549
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-05
Last Update Date:2012-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide