Provider Demographics
NPI:1992065643
Name:TEBID, MOSES MBAH
Entity type:Individual
Prefix:MR
First Name:MOSES
Middle Name:MBAH
Last Name:TEBID
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 1:6906 GOOD LUCK RD
Mailing Address - Street 2:
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-3707
Mailing Address - Country:US
Mailing Address - Phone:240-893-3250
Mailing Address - Fax:
Practice Address - Street 1:6906 GOOD LUCK RD
Practice Address - Street 2:
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-3707
Practice Address - Country:US
Practice Address - Phone:240-893-3250
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-29
Last Update Date:2012-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide