Provider Demographics
NPI:1992564868
Name:NAMULEME, MARIAM
Entity type:Individual
Prefix:MISS
First Name:MARIAM
Middle Name:
Last Name:NAMULEME
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 1:738 MAIN ST # 206
Mailing Address - Street 2:
Mailing Address - City:WALTHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02451-0616
Mailing Address - Country:US
Mailing Address - Phone:857-762-9716
Mailing Address - Fax:
Practice Address - Street 1:15 VILLAGE ROCK LN APT 7
Practice Address - Street 2:
Practice Address - City:NATICK
Practice Address - State:MA
Practice Address - Zip Code:01760-5711
Practice Address - Country:US
Practice Address - Phone:857-762-9716
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-14
Last Update Date:2024-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide