Doctor Name: | STEPHEN BOBGA GWANVOMA |
NPI Number: | 1619302585 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | HHA |
License Number: | |
Business Practice Address: | 670 W Kingsway Rd Middle River, MD - 212204925 |
Business Phone Number: | 2025450935 |
Business Fax Number: | 2025450176 |
Mailing Address: | 670 W Kingsway Rd, MIDDLE RIVER |
State: | MD |
Postal Code: | 212204925 |
Phone Number: | 2025450935 |
Fax Number: | 2025450176 |
NPI Enumeration Date: | 09/10/2013 |
NPI Last Update Date: | 09/10/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 374U00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Nursing Service Related Providers |
Taxonomy Classification: | Home Health Aide |
Taxonomy Specialization: | |
Taxonomy Definition: | A person trained to assist public health nurses, home health nurses, and other health professionals in the bedside care of patients in their homes. |