Provider Demographics
NPI:1932933033
Name:JALLOH, AMADU
Entity type:Individual
Prefix:
First Name:AMADU
Middle Name:
Last Name:JALLOH
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 1:5817 MOUZON DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43232-7486
Mailing Address - Country:US
Mailing Address - Phone:614-886-2874
Mailing Address - Fax:
Practice Address - Street 1:5817 MOUZON DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43232-7486
Practice Address - Country:US
Practice Address - Phone:614-886-2874
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-29
Last Update Date:2024-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker