Collins Moban Mukah

Primary specialty

Home Health AideTaxonomy code 374U00000X

Practice address

8709 63Rd Ave
Berwyn Heights, MD 20740-2763

Phone

(240) 920-4504

NPI assigned

Jan 6, 2021

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1609891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723766400000",
    "number": "1710575626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8709 63RD AVE",
            "city": "BERWYN HEIGHTS",
            "state": "MD",
            "postal_code": "207402763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8709 63RD AVE",
            "city": "BERWYN HEIGHTS",
            "state": "MD",
            "postal_code": "207402763",
            "telephone_number": "240-920-4504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUKAH",
        "first_name": "COLLINS",
        "middle_name": "MOBAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-01-06",
        "last_updated": "2024-08-16",
        "certification_date": "2024-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": "DC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Home Health Aide in Berwyn Heights, MD
• Providers in Berwyn Heights, MD by specialty
• Home Health Aide in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.