Provider Demographics
NPI:1427303528
Name:MALAITEKE, OUMAROU
Entity type:Individual
Prefix:
First Name:OUMAROU
Middle Name:
Last Name:MALAITEKE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:703 CHILLUM RD
Mailing Address - Street 2:#101
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20783-3321
Mailing Address - Country:US
Mailing Address - Phone:240-535-7338
Mailing Address - Fax:
Practice Address - Street 1:703 CHILLUM RD
Practice Address - Street 2:#101
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20783-3321
Practice Address - Country:US
Practice Address - Phone:240-535-7338
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-16
Last Update Date:2012-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide