Provider Demographics
NPI:1215615067
Name:YUNMBAM, MERCY
Entity type:Individual
Prefix:
First Name:MERCY
Middle Name:
Last Name:YUNMBAM
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 1:11033 SPYGLASS HILL CT
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20721-2348
Mailing Address - Country:US
Mailing Address - Phone:240-305-5241
Mailing Address - Fax:
Practice Address - Street 1:3005 BLADENSBURG RD NE STE 1
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20018-2265
Practice Address - Country:US
Practice Address - Phone:202-635-2330
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-10
Last Update Date:2023-07-27
Deactivation Date:2023-07-11
Deactivation Code:
Reactivation Date:2023-07-26
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator