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Individual

FIDELIS NDUM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
9003 BRIGHTLEA CT, LANHAM, MD 20706-2844
(240) 929-7191
Mailing address
9003 BRIGHTLEA CT, LANHAM, MD 20706-2844

Taxonomy

Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
HHA14264
DC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
HHA14264
DC
Enumeration date
02/07/2019
Last updated
02/07/2019
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