Provider Demographics
NPI:1194381004
Name:GAWUM, CHRISTABEL ANWI
Entity type:Individual
Prefix:
First Name:CHRISTABEL
Middle Name:ANWI
Last Name:GAWUM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 HEARTLAND CT
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20774-6098
Mailing Address - Country:US
Mailing Address - Phone:240-544-8037
Mailing Address - Fax:
Practice Address - Street 1:1200 HEARTLAND CT
Practice Address - Street 2:
Practice Address - City:UPPER MARLBORO
Practice Address - State:MD
Practice Address - Zip Code:20774-6098
Practice Address - Country:US
Practice Address - Phone:240-544-8037
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-15
Last Update Date:2019-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA14400374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide