Individual
STALONE WUNG TEM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
11505 DUCKETTOWN RD, LAUREL, MD 20708-9708
(505) 557-7764
Mailing address
11505 DUCKETTOWN RD, LAUREL, MD 20708-9708
(505) 557-7764
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000000001
—
DC
05
—
70344063
—
DC
Enumeration date
08/22/2022
Last updated
08/22/2022
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