Individual
STEPHEN AZEH TANJANG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
9216 HOBART ST, SPRINGDALE, MD 20774-5409
(240) 505-0787
Mailing address
9216 HOBART ST, SPRINGDALE, MD 20774-5409
(240) 505-0787
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN1005996
DC
374U00000X
Home Health Aide
—
DC
Other
Enumeration date
10/11/2012
Last updated
10/11/2012
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